Dr Dwight Eugene Clark, OD in Rancho Cordova, CA

Dr Dwight Eugene Clark, OD is a medicare enrolled "Optometrist" provider in Rancho Cordova, California. His current practice location is 11216 Trinity River Drive, Rancho Cordova, California. You can reach out to his office (for appointments etc.) via phone at (916) 635-6161.

Dr Dwight Eugene Clark is licensed to practice in California (license number 5512) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1043321169.

Contact Information

	Dr Dwight Eugene Clark, OD
	11216 Trinity River Drive, Rancho Cordova, CA 95670
	(916) 635-6161
	(916) 631-3788

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Dwight Eugene Clark
Gender	Male
Speciality	Optometrist
Location	11216 Trinity River Drive, Rancho Cordova, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1043321169
Provider Enumeration Date: 08/31/2006
Last Update Date: 11/28/2011

Medicare PECOS Information:

PECOS PAC ID: 4183812043
Enrollment ID: I20101220001104

Medical Identifiers

Medical identifiers for Dr Dwight Eugene Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1043321169	NPI	-	NPPES
SD0055120	Medicaid	CA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
152W00000X	Optometrist	5512 (California)	Primary

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. Dr Dwight Eugene Clark allows following entities to bill medicare on his behalf.

Provider Name	Joseph R Martel Md Inc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1841326824 PECOS PAC ID: 0648225904 Enrollment ID: O20050318000789

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. Dr Dwight Eugene 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
Dr Dwight Eugene Clark, OD 11216 Trinity River Drive, Rancho Cordova, CA 95670 Ph: (916) 635-6161	Dr Dwight Eugene Clark, OD 11216 Trinity River Drive, Rancho Cordova, CA 95670 Ph: (916) 635-6161

Reviews and Comments

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