Mrs Melissa Clark, PT in Southlake, TX - Medicare Physical Therapist Provider

Mrs Melissa Clark, PT is a medicare enrolled "Physical Therapist" provider in Southlake, Texas. Her current practice location is 910 E Southlake Blvd Ste 155, Southlake, Texas. You can reach out to her office (for appointments etc.) via phone at (817) 421-5000.

Mrs Melissa Clark is licensed to practice in Texas (license number 1116291) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1609585256.

Contact Information

	Mrs Melissa Clark, PT
	910 E Southlake Blvd Ste 155, Southlake, TX 76092-6389
	(817) 421-5000
	(972) 506-8733

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Melissa Clark
Gender	Female
Speciality	Physical Therapist
Location	910 E Southlake Blvd Ste 155, Southlake, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1609585256
Provider Enumeration Date: 11/22/2022
Last Update Date: 11/22/2022

Medicare PECOS Information:

PECOS PAC ID: 0941261994
Enrollment ID: I20221209000407

Medical Identifiers

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

Identifier	Type	State	Issuer
1609585256	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2251X0800X	Physical Therapist - Orthopedic	1116291 (Texas)	Secondary
225100000X	Physical Therapist	1116291 (Texas)	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. Mrs Melissa Clark allows following entities to bill medicare on her behalf.

Provider Name	Las Colinas Orthopedic Surgery & Sports Medicine Pa
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1952396996 PECOS PAC ID: 0547286304 Enrollment ID: O20051020000644

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. Mrs Melissa 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
Mrs Melissa Clark, PT 400 W Lbj Fwy Ste 330, Irving, TX 75063-3717 Ph: (972) 556-2885	Mrs Melissa Clark, PT 910 E Southlake Blvd Ste 155, Southlake, TX 76092-6389 Ph: (817) 421-5000

Reviews and Comments

Physical Therapist in Southlake, TX

Erin Goebel, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1545 E Southlake Blvd Ste 100, Southlake, TX 76092 Phone: 817-442-9300 Fax: 817-416-0108
Mrs. Lisa Alice Redding, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1940 E State Highway 114, Suite 150, Southlake, TX 76092 Phone: 817-424-3668 Fax: 817-442-8637
Whitney Holmans, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1545 E Southlake Blvd, Suite 100, Southlake, TX 76092 Phone: 817-442-9300 Fax: 682-651-1909
Jennifer Merimonti, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 101 Watermere Dr., Southlake, TX 76092 Phone: 817-431-8668
Kara Edgerton, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2813 W Southlake Blvd, Suite 110, Southlake, TX 76092 Phone: 817-310-8780 Fax: 817-310-8781
Raphael Augustus Sadiwa, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 180 State St Ste 225, Southlake, TX 76092 Phone: 866-839-6979
Theresa J Adame-brooks, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1545 E Southlake Blvd Ste 100, Southlake, TX 76092 Phone: 817-442-9300 Fax: 817-416-0108

Mrs Melissa Clark, PT - Medicare Physical Therapist in Southlake, TX