Dr Brent A Clark, DPM is a medicare enrolled "Podiatrist" provider in St.george, Utah. He went to California School Of Podiatric Medicine and graduated in 1999 and has 25 years of diverse experience with area of expertise as Podiatry. He is a member of the group practice Coral Desert Foot And Ankle Pc, Coral Desert Foot And Ankle Pc and his current practice location is
2762 Trasimeno Drive, St.george, Utah. You can reach out to his office (for appointments etc.) via phone at
(509) 301-1565.
Dr Brent A Clark is licensed to practice in Washington (license number PO00000693) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1407820418.
Healthcare Provider's Profile
| Full Name | Dr Brent A Clark |
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| Gender | Male |
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| Speciality | Podiatry |
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| Experience | 25 Years |
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| Location | 2762 Trasimeno Drive, St.george, Utah |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Brent A Clark attended and graduated from California School Of Podiatric Medicine in 1999
NPI Data:
- NPI Number: 1407820418
- Provider Enumeration Date: 02/15/2006
- Last Update Date: 01/12/2024
Medicare PECOS Information:
- PECOS PAC ID: 5890757363
- Enrollment ID: I20231025003869
Medical Identifiers
Medical identifiers for Dr Brent A Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1407820418 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 213E00000X | Podiatrist | PO00000693 (Washington) | Primary |
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | PO00000693 (Washington) | Secondary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Coral Desert Foot And Ankle Pc | 5597858621 | 2 |
| Coral Desert Foot And Ankle Pc | 5597858621 | 2 |
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 Brent A Clark allows following entities to bill medicare on his behalf.
| Provider Name | Coral Desert Foot & Ankle Pc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1548450901
PECOS PAC ID: 5597858621
Enrollment ID: O20070906000308 |
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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. Dr Brent A 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 Brent A Clark, DPM
2762 Trasimeno Drive,
St.george, UT 84770
Ph: (509) 301-1565 | Dr Brent A Clark, DPM
2762 Trasimeno Drive,
St.george, UT 84770
Ph: (509) 301-1565 |
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