Clark Kellogg, - Medicare Anesthesiologist Assistant in Mansfield, OH

Clark Kellogg, is a medicare enrolled "Anesthesiologist Assistant" in Mansfield, Ohio. His current practice location is 799 Lexington Ave, Mansfield, Ohio. You can reach out to his office (for appointments etc.) via phone at (419) 756-5133.

Clark Kellogg is licensed to practice in Ohio (license number 32698321) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1457098154.

Contact Information

Clark Kellogg,
799 Lexington Ave,
Mansfield, OH 44907-1906
(419) 756-5133
(419) 774-9707



Provider's Profile

Full NameClark Kellogg
GenderMale
SpecialityAnesthesiologist Assistant
Location799 Lexington Ave, Mansfield, Ohio
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1457098154
  • Provider Enumeration Date: 05/16/2022
  • Last Update Date: 01/09/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 5799155032
  • Enrollment ID: I20230103002254

Medical Identifiers

Medical identifiers for Clark Kellogg such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1457098154NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367H00000XAnesthesiologist Assistant 32698321 (Ohio)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. Clark Kellogg allows following entities to bill medicare on his behalf.
Entity NameAnesthesia Associates Of Mansfield, Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1407947815
PECOS PAC ID: 3870486624
Enrollment ID: O20040205000222

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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. Clark Kellogg 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
Clark Kellogg,
5910 Bluestone Way,
Lewis Center, OH 43035-7550

Ph: (614) 301-2639
Clark Kellogg,
799 Lexington Ave,
Mansfield, OH 44907-1906

Ph: (419) 756-5133

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Anesthesiologist Assistant Nurses in Mansfield, OH

Mr. Nathaniel A Walton, AA
Anesthesiologist Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 799 Lexington Ave, Mansfield, OH 44907
Phone: 419-756-5133    Fax: 419-774-9707
Wosen D Assefa,
Anesthesiologist Assistant
Medicare: Medicare Enrolled
Practice Location: 335 Glessner Ave, Mansfield, OH 44903
Phone: 216-816-6982    
Ms. Emily Bowling, AA
Anesthesiologist Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 799 Lexington Ave, Mansfield, OH 44907
Phone: 419-756-5133    Fax: 419-774-9707
Mr. Joel Baker,
Anesthesiologist Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 799 Lexington Ave, Mansfield, OH 44907
Phone: 419-756-5133    

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