Lonnie W Clark, CRNA in Woodland Park, CO - Medicare Certified Registered Nurse Anesthetist (crna)

Lonnie W Clark, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Woodland Park, Colorado. He graduated from nursing school in 2005 and has 19 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Diehl Anesthesia, Woodland Park Anesthesia Llc and his current practice location is 16420 W Us Highway 24, Woodland Park, Colorado. You can reach out to his office (for appointments etc.) via phone at (806) 790-3928.

Lonnie W Clark is licensed to practice in Texas (license number 690859) and he also participates in the medicare program. He may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1598777450.

Contact Information

	Lonnie W Clark, CRNA
	16420 W Us Highway 24, Woodland Park, CO 80863-8760
	(806) 790-3928
	Not Available

Map and Direction

Provider's Profile

Full Name	Lonnie W Clark
Gender	Male
Speciality	Certified Registered Nurse Anesthetist (crna)
Experience	19 Years
Location	16420 W Us Highway 24, Woodland Park, Colorado
Accepts Medicare Assignments	May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.

Medical Education and Training:

Lonnie W Clark graduated from nursing school in 2005

NPI Data:

NPI Number: 1598777450
Provider Enumeration Date: 08/12/2006
Last Update Date: 12/09/2020

Medicare PECOS Information:

PECOS PAC ID: 6406861038
Enrollment ID: I20081020000188

Medical Identifiers

Medical identifiers for Lonnie W Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1598777450	NPI	-	NPPES
179419001	Medicaid	TX
200073510A	Medicaid	OK
90739868	Medicaid	CO
67349	Medicaid	TX
147825100	Medicaid	TX
202004266	Medicaid	NM
147825101	Other	TX	FIRSTCARE COMMERCIAL
86092U	Other	TX	BC/BS
202004266	Other	NM	PRESBYTERIAN COMMERCIAL
86091U	Other	TX	HMO BLUE
64851729	Medicaid	NM

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	690859 (Texas)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Uchealth Pikes Peak Regional Hospital	Woodland park, CO	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Diehl Anesthesia	6800197575	19
Woodland Park Anesthesia Llc	3971771999	2

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. Lonnie W Clark allows following entities to bill medicare on his behalf.

Entity Name	Woodland Park Anesthesia Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1417249996 PECOS PAC ID: 3971771999 Enrollment ID: O20110719000292

Entity Name	Diehl Anesthesia
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1467833897 PECOS PAC ID: 6800197575 Enrollment ID: O20151229000111

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. Lonnie W 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
Lonnie W Clark, CRNA 420 Paisley Dr, Colorado Springs, CO 80906-8205 Ph: (806) 790-3928	Lonnie W Clark, CRNA 16420 W Us Highway 24, Woodland Park, CO 80863-8760 Ph: (806) 790-3928

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Woodland Park, CO

Mr. Brian Thomas Farstad, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 16420 W Us Highway 24, Pikes Peak Regional Hospital, Woodland Park, CO 80863 Phone: 607-207-7233
Ryan Bezzant, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 16420 W Us Highway 24, Woodland Park, CO 80863 Phone: 719-374-6060

Lonnie W Clark, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Woodland Park, CO