Kellan Fitzgerald Clark, DO - Medicare Urology in Hamilton, MT

Kellan Fitzgerald Clark, DO is a medicare enrolled "Urology" physician in Hamilton, Montana. He graduated from medical school in 2014 and has 10 years of diverse experience with area of expertise as Urology. He is a member of the group practice Marcus Daly Memorial Hospital Corporation and his current practice location is 215 N 10th St Ste A, Hamilton, Montana. You can reach out to his office (for appointments etc.) via phone at (406) 375-2930.

Kellan Fitzgerald Clark is licensed to practice in Montana (license number 71931) 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 1134539091.

Contact Information

Kellan Fitzgerald Clark, DO
215 N 10th St Ste A,
Hamilton, MT 59840-2328
(406) 375-2930
Not Available



Physician's Profile

Full NameKellan Fitzgerald Clark
GenderMale
SpecialityUrology
Experience10 Years
Location215 N 10th St Ste A, Hamilton, Montana
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:
  • Kellan Fitzgerald Clark graduated from medical school in 2014
  NPI Data:
  • NPI Number: 1134539091
  • Provider Enumeration Date: 04/30/2014
  • Last Update Date: 05/12/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 1850642497
  • Enrollment ID: I20191016000294

Medical Identifiers

Medical identifiers for Kellan Fitzgerald Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1134539091NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208800000XUrology 71931 (Montana)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Marcus Daly Memorial Hospital - CahHamilton, MTHospital
St. Patrick HospitalMissoula, MTHospital
Community Medical CenterMissoula, MTHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Marcus Daly Memorial Hospital Corporation559766447490

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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. Kellan Fitzgerald Clark allows following entities to bill medicare on his behalf.
Entity NameMarcus Daly Memorial Hospital Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1659475846
PECOS PAC ID: 5597664474
Enrollment ID: O20040202001033

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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. Kellan Fitzgerald 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
Kellan Fitzgerald Clark, DO
1200 Westwood Dr,
Hamilton, MT 59840-2345

Ph: () -
Kellan Fitzgerald Clark, DO
215 N 10th St Ste A,
Hamilton, MT 59840-2328

Ph: (406) 375-2930

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Urology Doctors in Hamilton, MT


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