Justin Charles Clark, MD - Medicare Neurosurgery in Grand Rapids, MI

Justin Charles Clark, MD is a medicare enrolled "Neurological Surgery" physician in Grand Rapids, Michigan. He went to University Of Michigan Medical School and graduated in 2007 and has 17 years of diverse experience with area of expertise as Neurosurgery. He is a member of the group practice Sheridan Community Hospital, Great Lakes Neurosurgical Associates Pc and his current practice location is 414 Plymouth Ne, Grand Rapids, Michigan. You can reach out to his office (for appointments etc.) via phone at (616) 454-3465.

Justin Charles Clark is licensed to practice in Michigan (license number 4301104141) 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 1598945644.

Contact Information

Justin Charles Clark, MD
414 Plymouth Ne,
Grand Rapids, MI 49505-6041
(616) 454-3465
(616) 242-7060



Physician's Profile

Full NameJustin Charles Clark
GenderMale
SpecialityNeurosurgery
Experience17 Years
Location414 Plymouth Ne, Grand Rapids, Michigan
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:
  • Justin Charles Clark attended and graduated from University Of Michigan Medical School in 2007
  NPI Data:
  • NPI Number: 1598945644
  • Provider Enumeration Date: 11/06/2007
  • Last Update Date: 06/26/2015
  Medicare PECOS Information:
  • PECOS PAC ID: 5991928590
  • Enrollment ID: I20140529001817

Medical Identifiers

Medical identifiers for Justin Charles Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1598945644NPI-NPPES
80762OtherAZTRAINING PERMIT
4301104141OtherMISTATE OF MICHIGAN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207T00000XNeurological Surgery 4301104141 (Michigan)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Metro Health HospitalWyoming, MIHospital
Spectrum HealthGrand rapids, MIHospital
Mercy Health Saint Mary'sGrand rapids, MIHospital
Sheridan Community HospitalSheridan, MIHospital
Spectrum Health United HospitalGreenville, MIHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Sheridan Community Hospital16582753424
Great Lakes Neurosurgical Associates Pc589069118213

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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. Justin Charles Clark allows following entities to bill medicare on his behalf.
Entity NameGreat Lakes Neurosurgical Associates Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1366590929
PECOS PAC ID: 5890691182
Enrollment ID: O20031209000125

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Entity NameSheridan Community Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1528090594
PECOS PAC ID: 1658275342
Enrollment ID: O20040315001133

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Entity NameSheridan Community Hospital
Entity TypePart A Provider - Critical Access Hospital
Entity IdentifiersNPI Number: 1689618324
PECOS PAC ID: 1658275342
Enrollment ID: O20070301000099

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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. Justin Charles 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
Justin Charles Clark, MD
414 Plymouth Ne,
Grand Rapids, MI 49505-6041

Ph: (616) 454-3465
Justin Charles Clark, MD
414 Plymouth Ne,
Grand Rapids, MI 49505-6041

Ph: (616) 454-3465

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Neurological Surgery Doctors in Grand Rapids, MI

Steve R Klafeta, MD
Neurological Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 245 Cherry St Se, Suite 207, Grand Rapids, MI 49503
Phone: 616-752-5137    
Robert John Seledotis, D.O., P.C.
Neurological Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 847 Parchment Dr Se Ste 125, Grand Rapids, MI 49546
Phone: 616-454-9246    Fax: 616-454-6839
Marilyn L.g. Gates, M.D.
Neurological Surgery
Medicare: Not Enrolled in Medicare
Practice Location: 25 Michigan St Ne, Suite 6100, Grand Rapids, MI 49503
Phone: 616-267-7900    Fax: 616-267-7901
Dr. Hayden Matthew Kevin Boyce, M.D.
Neurological Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 25 Michigan St Ne, Suite 6100, Grand Rapids, MI 49503
Phone: 616-267-7900    Fax: 616-267-7901
Dr. John E. Stevenson, M.D.
Neurological Surgery
Medicare: Not Enrolled in Medicare
Practice Location: 414 Plymouth Ave Ne, Grand Rapids, MI 49505
Phone: 616-454-3465    Fax: 616-454-9004
Dr. Joseph R. O'donnell, M.D.
Neurological Surgery
Medicare: Not Enrolled in Medicare
Practice Location: 414 Plymouth Ave Ne, Grand Rapids, MI 49505
Phone: 616-454-3465    Fax: 616-454-9004
Andres Felipe Restrepo Orozco, MD
Neurological Surgery
Medicare: Not Enrolled in Medicare
Practice Location: 25 Michigan St Ne Ste 6100, Grand Rapids, MI 49503
Phone: 616-267-7900    

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