Shalita Clark, CRNP in Bronx, NY - Medicare Nurse Practitioner

Shalita Clark, CRNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Bronx, New York. She graduated from nursing school in 2018 and has 6 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Downtown Bronx Medical Associates Pc and her current practice location is 234 E 149th St, Bronx, New York. You can reach out to her office (for appointments etc.) via phone at (718) 579-5006.

Shalita Clark is licensed to practice in Indiana (license number CV2100304) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1396214060.

Contact Information

	Shalita Clark, CRNP
	234 E 149th St, Bronx, NY 10451-5504
	(718) 579-5006
	Not Available

Map and Direction

Provider's Profile

Full Name	Shalita Clark
Gender	Female
Speciality	Nurse Practitioner
Experience	6 Years
Location	234 E 149th St, Bronx, New York
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Shalita Clark graduated from nursing school in 2018

NPI Data:

NPI Number: 1396214060
Provider Enumeration Date: 11/24/2018
Last Update Date: 04/22/2022

Medicare PECOS Information:

PECOS PAC ID: 1153662283
Enrollment ID: I20220118002506

Medical Identifiers

Medical identifiers for Shalita Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1396214060	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	402966V (New York)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	1-147364 (Alabama)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	95010591 (California)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	CV2100304 (Indiana)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Lincoln Medical & Mental Health Center	Bronx, NY	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Downtown Bronx Medical Associates Pc	9638082746	351

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. Shalita Clark allows following entities to bill medicare on her behalf.

Entity Name	Downtown Bronx Medical Associates Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1689618407 PECOS PAC ID: 9638082746 Enrollment ID: O20031106000016

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. Shalita 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
Shalita Clark, CRNP 234 E 149th St, Bronx, NY 10451-5589 Ph: (718) 579-5006	Shalita Clark, CRNP 234 E 149th St, Bronx, NY 10451-5504 Ph: (718) 579-5006

Reviews and Comments

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Silvia R Mehmel, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2514 Woodhull Ave, Bronx, NY 10469 Phone: 718-618-0401 Fax: 718-294-6276
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Ms. Charleen Jacobs, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3444 Kossuth Ave, Mmg Family Care Center, Bronx, NY 10467 Phone: 718-920-2273
Mrs. Keisha A Ballentine-cargill, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 841 Burke Ave, Bronx, NY 10467 Phone: 718-654-1726

Shalita Clark, CRNP - Medicare Nurse Practitioner in Bronx, NY