Clover Podiatry Pllc is a medicare enrolled "Podiatrist - Foot & Ankle Surgery" provider in Camas, Washington. Their current practice location is
405 Ne 6th Ave, Camas, Washington. You can reach out to their office (for appointments etc.) via phone at
(360) 450-6644.
Clover Podiatry Pllc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Clover Podiatry Pllc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1912525288.
Healthcare Provider's Profile
| Full Name | Clover Podiatry Pllc |
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| Type | Facility |
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| Speciality | Podiatrist - Foot & Ankle Surgery |
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| Location | 405 Ne 6th Ave, Camas, Washington |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1912525288
- Provider Enumeration Date: 07/13/2020
- Last Update Date: 01/22/2021
Medicare PECOS Information:
- PECOS PAC ID: 2466870118
- Enrollment ID: O20200914001003
Medical Identifiers
Medical identifiers for Clover Podiatry Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1912525288 | NPI | - | NPPES |
| 2169432 | Medicaid | WA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Clover Podiatry Pllc acts as a billing entity for following providers:
| Provider Name | Douglas B Rutan |
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| Provider Type | Practitioner - Podiatry |
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| Provider Identifiers | NPI Number: 1821081613
PECOS PAC ID: 7416033287
Enrollment ID: I20080320000098 |
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| Provider Name | Tek Fish |
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| Provider Type | Practitioner - Podiatry |
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| Provider Identifiers | NPI Number: 1245763127
PECOS PAC ID: 8729406475
Enrollment ID: I20201013001972 |
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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. Clover Podiatry Pllc 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 |
|---|
Clover Podiatry Pllc
405 Ne 6th Ave,
Camas, WA 98607-2037
Ph: (360) 450-6644 | Clover Podiatry Pllc
405 Ne 6th Ave,
Camas, WA 98607-2037
Ph: (360) 450-6644 |
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