Jacob Tyler Clark, MD - Medicare Emergency Medicine in Green Bay, WI

Jacob Tyler Clark, MD is a medicare enrolled "Emergency Medicine" physician in Green Bay, Wisconsin. He went to New York Medical College and graduated in 2016 and has 8 years of diverse experience with area of expertise as Emergency Medicine. He is a member of the group practice Aurora Health Care North Inc, Aurora Medical Center Of Oshkosh Inc, Aurora Medical Group, Inc., Baycare Aurora Llc, Baycare Clinic Llp and his current practice location is 2845 Greenbrier Rd, Green Bay, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (920) 288-4060.

Jacob Tyler Clark is licensed to practice in Wisconsin (license number 6446-851) 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 1437512613.

Contact Information

Jacob Tyler Clark, MD
2845 Greenbrier Rd,
Green Bay, WI 54311-6519
(920) 288-4060
(920) 288-4067



Physician's Profile

Full NameJacob Tyler Clark
GenderMale
SpecialityEmergency Medicine
Experience8 Years
Location2845 Greenbrier Rd, Green Bay, Wisconsin
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Jacob Tyler Clark attended and graduated from New York Medical College in 2016
  NPI Data:
  • NPI Number: 1437512613
  • Provider Enumeration Date: 04/04/2016
  • Last Update Date: 04/11/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 4688967417
  • Enrollment ID: I20190725003837

Medical Identifiers

Medical identifiers for Jacob Tyler Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1437512613NPI-NPPES
100057535MedicaidWI

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207P00000XEmergency Medicine 6446-851 (Wisconsin)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Aurora Baycare Medical CtrGreen bay, WIHospital
Aurora Medical Ctr Manitowoc CountyTwo rivers, WIHospital
Aurora Medical Ctr OshkoshOshkosh, WIHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Aurora Health Care North Inc943606740215
Aurora Medical Center Of Oshkosh Inc711383737811
Aurora Medical Group, Inc.67097942583207
Baycare Aurora Llc0244130557173
Baycare Clinic Llp4385554328185

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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. Jacob Tyler Clark allows following entities to bill medicare on his behalf.
Entity NameBaycare Clinic Llp
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1588609648
PECOS PAC ID: 4385554328
Enrollment ID: O20031105000087

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Entity NameAurora Medical Group, Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1427271378
PECOS PAC ID: 6709794258
Enrollment ID: O20031105000725

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Entity NameAurora Medical Center Of Oshkosh Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1275578064
PECOS PAC ID: 7113837378
Enrollment ID: O20031111000585

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Entity NameAurora Health Care North Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1477508687
PECOS PAC ID: 9436067402
Enrollment ID: O20040211000368

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Entity NameBaycare Aurora Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1255387726
PECOS PAC ID: 0244130557
Enrollment ID: O20051012000579

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Within many hormone-receptor positive breast cancers lives a subpopulation of receptor-negative cells - knock down the hormone-receptor positive cells with anti-estrogen drugs and you may inadvertently promote tumor takeover by more dangerous, receptor-negative cells.

First Edition: August 16, 2011

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› Verified 8 days ago

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. Jacob Tyler 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
Jacob Tyler Clark, MD
1035 Kepler Dr,
Green Bay, WI 54311-8320

Ph: (920) 490-9046
Jacob Tyler Clark, MD
2845 Greenbrier Rd,
Green Bay, WI 54311-6519

Ph: (920) 288-4060

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First Edition: August 16, 2011

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› Verified 8 days ago


Emergency Medicine Doctors in Green Bay, WI

Katie Lynn Lloyd, DO
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 2845 Greenbrier Rd, Green Bay, WI 54311
Phone: 920-288-4060    Fax: 920-288-4067
Darren M Heesacker, MD
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 2845 Greenbrier Rd, Green Bay, WI 54311
Phone: 920-288-4060    Fax: 920-288-4067
Steven J Stroman, MD
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 2845 Greenbrier Rd, Green Bay, WI 54311
Phone: 920-288-4060    Fax: 920-288-4067
Edward C Vogel, MD
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 2845 Greenbrier Rd, Green Bay, WI 54311
Phone: 920-288-4060    Fax: 920-288-4067
Dr. David Franklin Edwards, M.D
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 3263 Eaton Rd, Green Bay, WI 54311
Phone: 920-433-6000    Fax: 920-433-6009
Dr. David Alan Sorrentino, D.O.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 2845 Greenbrier Rd, Green Bay, WI 54311
Phone: 920-288-4060    Fax: 920-288-4067
Dr. Ryan Thomas Murphy, MD
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 2845 Greenbrier Rd, Green Bay, WI 54311
Phone: 920-288-4060    Fax: 920-288-4067

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