Dr Kristie M Clark, MD - Medicare Pediatrics in Elkhart, KS

Dr Kristie M Clark, MD is a medicare enrolled "Pediatrics" physician in Elkhart, Kansas. Her current practice location is 445 Hilltop, Elkhart, Kansas. You can reach out to her office (for appointments etc.) via phone at (620) 697-2141.

Dr Kristie M Clark is licensed to practice in Kansas (license number 04-34215) 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 1558473884.

Contact Information

Dr Kristie M Clark, MD
445 Hilltop,
Elkhart, KS 67950
(620) 697-2141
(620) 741-8203



Physician's Profile

Full NameDr Kristie M Clark
GenderFemale
SpecialityPediatrics
Location445 Hilltop, Elkhart, Kansas
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1558473884
  • Provider Enumeration Date: 08/31/2006
  • Last Update Date: 09/22/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 5698776920
  • Enrollment ID: I20230825002670

Medical Identifiers

Medical identifiers for Dr Kristie M Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1558473884NPI-NPPES
0082EVOtherTXBLUE CROSS/BLUE SHIELD
137227810MedicaidTX

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208000000XPediatrics L6831 (Texas)Secondary
208000000XPediatrics 04-34215 (Kansas)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. Dr Kristie M Clark allows following entities to bill medicare on her behalf.
Entity NameVictory Clinic Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1104540079
PECOS PAC ID: 8729459607
Enrollment ID: O20230201001812

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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 Kristie M 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
Dr Kristie M Clark, MD
445 Hilltop,
Elkhart, KS 67950

Ph: (620) 697-2141
Dr Kristie M Clark, MD
445 Hilltop,
Elkhart, KS 67950

Ph: (620) 697-2141

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Pediatrics Doctors in Elkhart, KS


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