Lisa Diane Clark, FNP in Portland, OR - Medicare Nurse Practitioner

Lisa Diane Clark, FNP is a medicare enrolled "Nurse Practitioner - Family" in Portland, Oregon. She graduated from nursing school in 2004 and has 20 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Northwest Cancer Specialists Pc and her current practice location is 265 N Broadway St, Portland, Oregon. You can reach out to her office (for appointments etc.) via phone at (503) 274-4885.

Lisa Diane Clark is licensed to practice in Oregon (license number 200550098) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1942276282.

Contact Information

	Lisa Diane Clark, FNP
	265 N Broadway St, Portland, OR 97227-1800
	(503) 274-4885
	(503) 274-4814

Map and Direction

Provider's Profile

Full Name	Lisa Diane Clark
Gender	Female
Speciality	Nurse Practitioner
Experience	20 Years
Location	265 N Broadway St, Portland, Oregon
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Lisa Diane Clark graduated from nursing school in 2004

NPI Data:

NPI Number: 1942276282
Provider Enumeration Date: 02/27/2006
Last Update Date: 12/22/2011

Medicare PECOS Information:

PECOS PAC ID: 7012922438
Enrollment ID: I20060317000164

Medical Identifiers

Medical identifiers for Lisa Diane Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1942276282	NPI	-	NPPES
273968	Medicaid	OR
1022791	Medicaid	WA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	200550098 (Oregon)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Northwest Cancer Specialists Pc	8426943838	53

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. Lisa Diane Clark allows following entities to bill medicare on her behalf.

Entity Name	Northwest Cancer Specialists Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1407828114 PECOS PAC ID: 8426943838 Enrollment ID: O20040217000848

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. Lisa Diane 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
Lisa Diane Clark, FNP 265 N Broadway St, Portland, OR 97227-1800 Ph: (503) 274-4885	Lisa Diane Clark, FNP 265 N Broadway St, Portland, OR 97227-1800 Ph: (503) 274-4885

Reviews and Comments

Nurse Practitioner Nurses in Portland, OR

Mrs. Anjalee Nix Rowe, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 Phone: 503-494-3988
Ms. Susan Irene Smith, RN, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5100 Sw Macadam Ave, Suite 200, Portland, OR 97239 Phone: 971-202-5500 Fax: 971-202-5555
Iva Juric, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3181 Sw Sam Jackson Park Rd # Cdw6, Portland, OR 97239 Phone: 503-494-4808
Ms. Jessica A Dudley, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3550 N Interstate Ave, Portland, OR 97227 Phone: 503-746-1575
Summer Morgan Massina, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 721 Nw 9th Ave Ste 100, Portland, OR 97209 Phone: 503-525-0090
Dr. Jeffery Wise, PMHNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1834 Nw 25th Ave Apt 504, Portland, OR 97210 Phone: 971-354-9242
A'lissa Richards, PMHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 12121 E Burnside St, Portland, OR 97216 Phone: 971-361-7700

Lisa Diane Clark, FNP - Medicare Nurse Practitioner in Portland, OR