Carolyn Chen Clark, MD - Medicare Diagnostic Radiology in Kailua, HI

Carolyn Chen Clark, MD is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Kailua, Hawaii. She went to University Of Washington School Of Medicine and graduated in 2015 and has 9 years of diverse experience with area of expertise as Diagnostic Radiology. She is a member of the group practice Virginia Mason Medical Center, Virginia Mason Medical Center and her current practice location is 640 Ulukahiki St, Kailua, Hawaii. You can reach out to her office (for appointments etc.) via phone at (503) 251-6855.

Carolyn Chen Clark is licensed to practice in Hawaii (license number 21521) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1336536036.

Contact Information

Carolyn Chen Clark, MD
640 Ulukahiki St,
Kailua, HI 96734-4454
(503) 251-6855
Not Available



Physician's Profile

Full NameCarolyn Chen Clark
GenderFemale
SpecialityDiagnostic Radiology
Experience9 Years
Location640 Ulukahiki St, Kailua, Hawaii
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Carolyn Chen Clark attended and graduated from University Of Washington School Of Medicine in 2015
  NPI Data:
  • NPI Number: 1336536036
  • Provider Enumeration Date: 04/20/2015
  • Last Update Date: 04/12/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 9931413564
  • Enrollment ID: I20210518002669

Medical Identifiers

Medical identifiers for Carolyn Chen Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1336536036NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2085R0202XRadiology - Diagnostic Radiology 21521 (Hawaii)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Virginia Mason Medical CenterSeattle, WAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Virginia Mason Medical Center9830002617825
Virginia Mason Medical Center9830002617825

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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. Carolyn Chen Clark allows following entities to bill medicare on her behalf.
Entity NameDiagnostic Radiologists Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1053368563
PECOS PAC ID: 4183510902
Enrollment ID: O20170705003169

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Entity NameVirginia Mason Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1124176904
PECOS PAC ID: 9830002617
Enrollment ID: O20211201001790

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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. Carolyn Chen 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 AddressPractice Location Address
Carolyn Chen Clark, MD
Po Box 16961,
Portland, OR 97292-0961

Ph: (503) 251-6855
Carolyn Chen Clark, MD
640 Ulukahiki St,
Kailua, HI 96734-4454

Ph: (503) 251-6855

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Radiology Doctors in Kailua, HI

Dr. Asti Pilika, M.D.
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 611 Milokai Pl, Kailua, HI 96734
Phone: 084-162-9322    Fax: 855-673-9190
Calvin B. Delaplain, M.D.
Radiology
Medicare: Not Enrolled in Medicare
Practice Location: 1301 Aulepe St, Kailua, HI 96734
Phone: 808-263-1958    
Dr. Norman T Ikemoto, MD
Radiology
Medicare: Not Enrolled in Medicare
Practice Location: 640 Ulukahiki St, Kailua, HI 96734
Phone: 808-263-5166    Fax: 808-263-5167
Dr. Venerando Seguritan, MD
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 640 Ulukahiki St, Kailua, HI 96734
Phone: 808-263-5166    Fax: 808-263-5167

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