Matthew Ryan Clark, MD - Medicare Dermatology in Charlotte, NC

Matthew Ryan Clark, MD is a medicare enrolled "Dermatology - Mohs-micrographic Surgery" physician in Charlotte, North Carolina. He went to University Of Florida College Of Medicine and graduated in 2013 and has 11 years of diverse experience with area of expertise as Dermatology. He is a member of the group practice Dermatologic Surgery Of The Carolinas Llc, Dermatologic Surgery Of The Carolinas Llc and his current practice location is 15830 Ballantyne Medical Pl Ste 225, Charlotte, North Carolina. You can reach out to his office (for appointments etc.) via phone at (704) 919-1105.

Matthew Ryan Clark is licensed to practice in Oregon (license number MD195653) 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 1194162230.

Contact Information

Matthew Ryan Clark, MD
15830 Ballantyne Medical Pl Ste 225,
Charlotte, NC 28277-0760
(704) 919-1105
(704) 910-3163



Physician's Profile

Full NameMatthew Ryan Clark
GenderMale
SpecialityDermatology
Experience11 Years
Location15830 Ballantyne Medical Pl Ste 225, Charlotte, North Carolina
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:
  • Matthew Ryan Clark attended and graduated from University Of Florida College Of Medicine in 2013
  NPI Data:
  • NPI Number: 1194162230
  • Provider Enumeration Date: 05/30/2013
  • Last Update Date: 08/29/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 1153564380
  • Enrollment ID: I20230808003577

Medical Identifiers

Medical identifiers for Matthew Ryan Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1194162230NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207N00000XDermatology 2023-00924 (North Carolina)Secondary
207N00000XDermatology MMD89666MD (South Carolina)Secondary
207ND0101XDermatology - Mohs-micrographic Surgery 2023-00924 (North Carolina)Secondary
207ND0101XDermatology - Mohs-micrographic Surgery MMD89666MD (South Carolina)Secondary
207ND0101XDermatology - Mohs-micrographic Surgery MD195653 (Oregon)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Dermatologic Surgery Of The Carolinas Llc15574485373
Dermatologic Surgery Of The Carolinas Llc15574485373

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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. Matthew Ryan Clark allows following entities to bill medicare on his behalf.
Entity NameDermatologic Surgery Of The Carolinas Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1790961670
PECOS PAC ID: 1557448537
Enrollment ID: O20080402000293

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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. Matthew Ryan 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
Matthew Ryan Clark, MD
1390 S Potomac St Ste 124,
Aurora, CO 80012-4529

Ph: (303) 368-8611
Matthew Ryan Clark, MD
15830 Ballantyne Medical Pl Ste 225,
Charlotte, NC 28277-0760

Ph: (704) 919-1105

News Archive

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Dermatology Doctors in Charlotte, NC

Dr. Coleman Eric Altman, D.O.
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 2630 E Seventh St, Suite 200, Charlotte, NC 28204
Phone: 704-364-6110    Fax: 704-364-4245
Sam Wu, MD
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 309 S Sharon Amity Rd Ste 200, Charlotte, NC 28211
Phone: 704-344-8846    
Dr. Deborah Gardner Nixon, MD
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 8936 Blakeney Professional Dr, Charlotte, NC 28277
Phone: 704-341-0090    Fax: 704-341-0092
Dr. Curtis Wayne Schupbach, MD
Dermatology
Medicare: Medicare Enrolled
Practice Location: 2620 E 7th St, Charlotte, NC 28204
Phone: 704-358-9900    Fax: 704-344-0105
Daren Diiorio, MD
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 4525 Cameron Valley Pkwy, Ste 2100, Charlotte, NC 28211
Phone: 704-355-5100    
Dr. Marc Alan Darst, MD
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 11301 Golf Links Dr N, Suite 203, Charlotte, NC 28277
Phone: 704-321-3376    Fax: 704-541-6558
Jonathan M Olson, MD
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 15830 Ballantyne Medical Pl, Suite 225, Charlotte, NC 28277
Phone: 704-919-1105    Fax: 704-910-3163

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