Dr Theresa L Clark, MD - Medicare Psychiatry in Dillon, CO

Dr Theresa L Clark, MD is a medicare enrolled "Psychiatry & Neurology - Psychiatry" physician in Dillon, Colorado. She graduated from medical school in 2007 and has 17 years of diverse experience with area of expertise as Psychiatry. Her current practice location is 114 Village Place, St 207, Dillon, Colorado. You can reach out to her office (for appointments etc.) via phone at (970) 455-9004.

Dr Theresa L Clark is licensed to practice in Colorado (license number DR.0061413) 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 1104015155.

Contact Information

Dr Theresa L Clark, MD
114 Village Place, St 207,
Dillon, CO 80435
(970) 455-9004
(949) 577-4247

Map and Direction




Physician's Profile

Full NameDr Theresa L Clark
GenderFemale
SpecialityPsychiatry
Experience17 Years
Location114 Village Place, Dillon, Colorado
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Theresa L Clark graduated from medical school in 2007
  NPI Data:
  • NPI Number: 1104015155
  • Provider Enumeration Date: 10/16/2007
  • Last Update Date: 04/14/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 2062680010
  • Enrollment ID: I20190501000062

Medical Identifiers

Medical identifiers for Dr Theresa L Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1104015155NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2084P0800XPsychiatry & Neurology - Psychiatry 35.135479 (Ohio)Secondary
2084P0800XPsychiatry & Neurology - Psychiatry ME104695 (Florida)Secondary
390200000XStudent In An Organized Health Care Education/training Program TRN11797 (Florida)Secondary
2084P0800XPsychiatry & Neurology - Psychiatry DR.0061413 (Colorado)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Denver Health & Hospital AuthorityDenver, COHospital

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. Dr Theresa L Clark allows following entities to bill medicare on her behalf.
Entity NameDenver Health And Hospital Authority
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1477569838
PECOS PAC ID: 4688583578
Enrollment ID: O20031105000211
Entity NameTen Mile Health & Wellness Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1417538281
PECOS PAC ID: 9032528393
Enrollment ID: O20210518000039

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. Dr Theresa L 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
Dr Theresa L Clark, MD
Po Box 2098,
Dillon, CO 80435-2098

Ph: (970) 455-9004
Dr Theresa L Clark, MD
114 Village Place, St 207,
Dillon, CO 80435

Ph: (970) 455-9004

Reviews and Comments


Psychiatry & Neurology Doctors in Dillon, CO


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.