Mrs Diane K Clark, ACNP in Portland, OR - Medicare Nurse Practitioner

Mrs Diane K Clark, ACNP is a medicare enrolled "Nurse Practitioner - Acute Care" in Portland, Oregon. She went to University Of Utah School Of Medicine and graduated in 2008 and has 16 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Providence Health And Services Oregon and her current practice location is 9427 Sw Barnes Rd, Ste 595, Portland, Oregon. You can reach out to her office (for appointments etc.) via phone at (503) 216-1150.

Mrs Diane K Clark is licensed to practice in Oregon (license number 201150003NP) 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 1881863488.

Contact Information

	Mrs Diane K Clark, ACNP
	9427 Sw Barnes Rd, Ste 595, Portland, OR 97225-6640
	(503) 216-1150
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Diane K Clark
Gender	Female
Speciality	Nurse Practitioner
Experience	16 Years
Location	9427 Sw Barnes Rd, 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:

Mrs Diane K Clark attended and graduated from University Of Utah School Of Medicine in 2008

NPI Data:

NPI Number: 1881863488
Provider Enumeration Date: 02/27/2008
Last Update Date: 02/19/2021

Medicare PECOS Information:

PECOS PAC ID: 3274660493
Enrollment ID: I20110325000419

Medical Identifiers

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

Identifier	Type	State	Issuer
1881863488	NPI	-	NPPES
P00957594	Other	OR	RR MEDICARE
500631611	Medicaid	OR

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LA2100X	Nurse Practitioner - Acute Care	278877-4405 (Utah)	Secondary
364SC0200X	Clinical Nurse Specialist - Critical Care Medicine	278877-4405 (Utah)	Secondary
363LA2100X	Nurse Practitioner - Acute Care	201150003NP (Oregon)	Primary
363L00000X	Nurse Practitioner	201150003NP (Oregon)	Secondary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Providence St Vincent Medical Center	Portland, OR	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Providence Health And Services Oregon	0648183608	1344

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

Entity Name	Providence Health & Services Oregon
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1023488343 PECOS PAC ID: 0648183608 Enrollment ID: O20031106000652

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. Mrs Diane K 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
Mrs Diane K Clark, ACNP Po Box 3158, Portland, OR 97208-3158 Ph: (503) 215-6494	Mrs Diane K Clark, ACNP 9427 Sw Barnes Rd, Ste 595, Portland, OR 97225-6640 Ph: (503) 216-1150

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

Mrs Diane K Clark, ACNP - Medicare Nurse Practitioner in Portland, OR