Ryan Mathew Clark, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Bolivar, MO

Ryan Mathew Clark, CRNA is a medicare enrolled "Anesthesiologist Assistant" in Bolivar, Missouri. He graduated from nursing school in 2011 and has 13 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Citizens Memorial Hospital District and his current practice location is 1500 N Oakland, Bolivar, Missouri. You can reach out to his office (for appointments etc.) via phone at (417) 328-7705.

Ryan Mathew Clark is licensed to practice in Missouri (license number 2011022952) 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 1184903460.

Contact Information

Ryan Mathew Clark, CRNA
1500 N Oakland,
Bolivar, MO 65613-3099
(417) 328-7705
Not Available



Provider's Profile

Full NameRyan Mathew Clark
GenderMale
SpecialityCertified Registered Nurse Anesthetist (crna)
Experience13 Years
Location1500 N Oakland, Bolivar, Missouri
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:
  • Ryan Mathew Clark graduated from nursing school in 2011
  NPI Data:
  • NPI Number: 1184903460
  • Provider Enumeration Date: 08/04/2011
  • Last Update Date: 08/04/2011
  Medicare PECOS Information:
  • PECOS PAC ID: 0648442566
  • Enrollment ID: I20111018000606

Medical Identifiers

Medical identifiers for Ryan Mathew Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1184903460NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367H00000XAnesthesiologist Assistant 2011022952 (Missouri)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Citizens Memorial HospitalBolivar, MOHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Citizens Memorial Hospital District276957443328

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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. Ryan Mathew Clark allows following entities to bill medicare on his behalf.
Entity NameCitizens Memorial Hospital District
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1558548818
PECOS PAC ID: 2769574433
Enrollment ID: O20070827000044

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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. Ryan Mathew 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
Ryan Mathew Clark, CRNA
1500 N Oakland,
Bolivar, MO 65613-3099

Ph: (417) 328-7705
Ryan Mathew Clark, CRNA
1500 N Oakland,
Bolivar, MO 65613-3099

Ph: (417) 328-7705

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Anesthesiologist Assistant Nurses in Bolivar, MO


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