DR. EDWARD PETERSEN CLACK DO
NPI 1659629053
Family Medicine in Dayton, OH
About Dr. Edward Petersen Clack Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. EDWARD PETERSEN CLACK DO (NPI 1659629053) is an individual family medicine provider in Dayton, Ohio, licensed in Ohio (34.011463) and active in the NPI registry since August 2012. He is enrolled in Medicare PECOS, is affiliated with Miami Valley Hospital, and is a graduate of At Still University Of Health Sciences, College Of Osteo Med, Kirksville (2012).
NPPES Registry Identity
Specialties & Licenses
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Edward Petersen Clack Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Areas of Expertise CMS Part B claims 6
Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare 4
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Miami Valley Hospital
Acute Care Hospitals · Dayton, OHKettering Health Main Campus
Acute Care Hospitals · Kettering, OHKettering Health Dayton
Acute Care Hospitals · Dayton, OHSoin Medical Center
Acute Care Hospitals · Beaver Creek, OHPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 45415 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Referred Medical Equipment & Supplies CMS DME claims 3
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1659629053, enumerated as an "individual" on August 16, 2012.
The provider is located at 5900 N MAIN ST STE 3 DAYTON, OH 45415 and the phone number is (937) 277-9371.
Family Medicine with taxonomy code 207Q00000X.
The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.
Edward Clack is affiliated with: MIAMI VALLEY HOSPITAL, KETTERING HEALTH MAIN CAMPUS, KETTERING HEALTH DAYTON and SOIN MEDICAL CENTER.
