Deanna R Clark, CFNP in Albuquerque, NM - Medicare Nurse Practitioner

Deanna R Clark, CFNP is a medicare enrolled "Nurse Practitioner - Family" in Albuquerque, New Mexico. Her current practice location is 4225 Montgomery Blvd Ne, Albuquerque, New Mexico. You can reach out to her office (for appointments etc.) via phone at (505) 366-3635.

Deanna R Clark is licensed to practice in New Mexico (license number CNP-03049) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1477003366.

Contact Information

	Deanna R Clark, CFNP
	4225 Montgomery Blvd Ne, Albuquerque, NM 87109-1103
	(505) 366-3635
	(505) 221-5429

Map and Direction

Provider's Profile

Full Name	Deanna R Clark
Gender	Female
Speciality	Nurse Practitioner - Family
Location	4225 Montgomery Blvd Ne, Albuquerque, New Mexico
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1477003366
Provider Enumeration Date: 10/04/2016
Last Update Date: 09/23/2021

Medicare PECOS Information:

PECOS PAC ID: 3274800776
Enrollment ID: I20170606000080

Medical Identifiers

Medical identifiers for Deanna R Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1477003366	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	CNP-03049 (New Mexico)	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. Deanna R Clark allows following entities to bill medicare on her behalf.

Entity Name	Four Humours Healthcare Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1043376346 PECOS PAC ID: 3476658998 Enrollment ID: O20070411000482

Entity Name	Signify Health Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1689158487 PECOS PAC ID: 3274895263 Enrollment ID: O20210512001500

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. Deanna R 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 Address	Practice Location Address
Deanna R Clark, CFNP 4225 Montgomery Blvd Ne, Albuquerque, NM 87109-1103 Ph: (505) 366-3635	Deanna R Clark, CFNP 4225 Montgomery Blvd Ne, Albuquerque, NM 87109-1103 Ph: (505) 366-3635

Reviews and Comments

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Deanna R Clark, CFNP - Medicare Nurse Practitioner in Albuquerque, NM