Skylar Clark, DPT is a medicare enrolled "Physical Therapist" provider in San Ysidro, California. Her current practice location is
3364 Beyer Blvd, San Ysidro, California. You can reach out to her office (for appointments etc.) via phone at
(619) 205-4585.
Skylar Clark is licensed to practice in California (license number PT302385) 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 1457089187.
Healthcare Provider's Profile
| Full Name | Skylar Clark |
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| Gender | Female |
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| Speciality | Physical Therapist |
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| Location | 3364 Beyer Blvd, San Ysidro, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1457089187
- Provider Enumeration Date: 08/10/2022
- Last Update Date: 08/10/2022
Medicare PECOS Information:
- PECOS PAC ID: 1951777895
- Enrollment ID: I20221018003422
Medical Identifiers
Medical identifiers for Skylar Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1457089187 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225100000X | Physical Therapist | PT302385 (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. Skylar Clark allows following entities to bill medicare on her behalf.
| Provider Name | Sharp Rees-stealy Medical Group Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1285616177
PECOS PAC ID: 8628972759
Enrollment ID: O20031120000996 |
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| Provider Name | Centro De Salud De La Comunidad De San Ysidro, Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1124782685
PECOS PAC ID: 6901709435
Enrollment ID: O20040130000711 |
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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. Skylar 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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Skylar Clark, DPT
2141 Front St Apt B,
San Diego, CA 92101-1928
Ph: () - | Skylar Clark, DPT
3364 Beyer Blvd,
San Ysidro, CA 92173-1322
Ph: (619) 205-4585 |
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