Ryan Mathew Clark, CRNA is a medicare enrolled "Anesthesiologist Assistant" in Bolivar, Missouri. He graduated from nursing school in 2011 and has 13 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Citizens Memorial Hospital District and his current practice location is
1500 N Oakland, Bolivar, Missouri. You can reach out to his office (for appointments etc.) via phone at
(417) 328-7705.
Ryan Mathew Clark is licensed to practice in Missouri (license number 2011022952) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1184903460.
Provider's Profile
| Full Name | Ryan Mathew Clark |
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| Gender | Male |
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| Speciality | Certified Registered Nurse Anesthetist (crna) |
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| Experience | 13 Years |
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| Location | 1500 N Oakland, Bolivar, Missouri |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Ryan Mathew Clark graduated from nursing school in 2011
NPI Data:
- NPI Number: 1184903460
- Provider Enumeration Date: 08/04/2011
- Last Update Date: 08/04/2011
Medicare PECOS Information:
- PECOS PAC ID: 0648442566
- Enrollment ID: I20111018000606
Medical Identifiers
Medical identifiers for Ryan Mathew Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1184903460 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 367H00000X | Anesthesiologist Assistant | 2011022952 (Missouri) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Citizens Memorial Hospital District | 2769574433 | 27 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ryan Mathew Clark allows following entities to bill medicare on his behalf.
| Entity Name | Citizens Memorial Hospital District |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1558548818
PECOS PAC ID: 2769574433
Enrollment ID: O20070827000044 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ryan Mathew Clark is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Ryan Mathew Clark, CRNA
1500 N Oakland,
Bolivar, MO 65613-3099
Ph: (417) 328-7705 | Ryan Mathew Clark, CRNA
1500 N Oakland,
Bolivar, MO 65613-3099
Ph: (417) 328-7705 |
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