Kelli Anne Clark, NP - Medicare Nurse Practitioner in Highland, CA

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Kelli Anne Clark, NP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Highland, California. Her current practice location is 27259 Nona Ave, Highland, California. You can reach out to her office (for appointments etc.) via phone at (909) 633-2647.

Kelli Anne Clark is licensed to practice in California (license number 95018043) 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 1750070918.

Contact Information

Kelli Anne Clark, NP
27259 Nona Ave,
Highland, CA 92346-2525
(909) 633-2647
Not Available

Map and Direction




Provider's Profile

Full NameKelli Anne Clark
GenderFemale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location27259 Nona Ave, Highland, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1750070918
  • Provider Enumeration Date: 05/03/2023
  • Last Update Date: 05/03/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 4385092741
  • Enrollment ID: I20231122002558

Medical Identifiers

Medical identifiers for Kelli Anne Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1750070918NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0808XNurse Practitioner - Psychiatric/mental Health 95018043 (California)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. Kelli Anne Clark allows following entities to bill medicare on her behalf.
Entity NameInlandpsych Redlands Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1053575738
PECOS PAC ID: 0749337467
Enrollment ID: O20090416000117

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. Kelli Anne 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
Kelli Anne Clark, NP
27259 Nona Ave,
Highland, CA 92346-2525

Ph: (909) 633-2647		Kelli Anne Clark, NP
27259 Nona Ave,
Highland, CA 92346-2525

Ph: (909) 633-2647

Reviews and Comments


Nurse Practitioner Nurses in Highland, CA

Ms. Marcella C Gutierrez, FNP, NP-C
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Practice Location: 7000 Boulder Ave, Highland, CA 92346
Phone: 909-862-1191    Fax: 909-862-2768
Christie Anne Laciste, NP
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Medicare: Medicare Enrolled
Practice Location: 7000 Boulder Ave, Highland, CA 92346
Phone: 909-862-1191    
Saulina Marpaung, N.P
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Practice Location: 7000 Boulder Ave, Highland, CA 92346
Phone: 909-862-1191    
Mrs. Tina Teresa Hall, FNP
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Medicare: Not Enrolled in Medicare
Practice Location: 29080 Marcus Ln, Highland, CA 92346
Phone: 909-633-2648    
Claire Loden, DNP, FNP
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Medicare: Accepting Medicare Assignments
Practice Location: 7000 Boulder Ave, Highland, CA 92346
Phone: 909-862-1191    
Charlene De Grassi, FNP-C
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Medicare: Accepting Medicare Assignments
Practice Location: 7000 Boulder Ave, Highland, CA 92346
Phone: 909-862-1191    Fax: 909-425-3331
Dr. Merrick Maynard Tsai, MD, FNP-BC, FNP-C
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 28839 Lemon St, Highland, CA 92346
Phone: 909-742-9889    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.