Mary Ellen Clark, CFNP - Medicare Nurse Practitioner in Warren, IN

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Mary Ellen Clark, CFNP is a medicare enrolled "Nurse Practitioner - Family" in Warren, Indiana. She graduated from nursing school in 2012 and has 13 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Lost Rivers Medical Center and her current practice location is 824 Huntington Ave, Warren, Indiana. You can reach out to her office (for appointments etc.) via phone at (260) 375-2965.

Mary Ellen Clark is licensed to practice in Indiana (license number 71016668A) 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 1891031621.

Contact Information

Mary Ellen Clark, CFNP
824 Huntington Ave,
Warren, IN 46792-9277
(260) 375-2965
(260) 375-2969

Map and Direction




Provider's Profile

Full NameMary Ellen Clark
GenderFemale
SpecialityNurse Practitioner
Experience13 Years
Location824 Huntington Ave, Warren, Indiana
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:
  • Mary Ellen Clark graduated from nursing school in 2012
  NPI Data:
  • NPI Number: 1891031621
  • Provider Enumeration Date: 12/26/2012
  • Last Update Date: 10/07/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 9739333824
  • Enrollment ID: I20220419002472

Medical Identifiers

Medical identifiers for Mary Ellen Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1891031621NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family CNP-02460 (New Mexico)Secondary
363LF0000XNurse Practitioner - Family 71016668A (Indiana)Primary
363LP2300XNurse Practitioner - Primary Care 66049 (Idaho)Secondary
363LF0000XNurse Practitioner - Family 201250210NP (Oregon)Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Eden Home HealthAmmon, IDHome health agency
Brio Idaho Home Health LlcIdaho falls, IDHome health agency
Lost Rivers Medical CenterArco, IDHospital
Portneuf Medical CenterPocatello, IDHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Lost Rivers Medical Center78108074279

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. Mary Ellen Clark allows following entities to bill medicare on her behalf.
Entity NameLost Rivers Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1427062181
PECOS PAC ID: 7810807427
Enrollment ID: O20040612000135
Entity NameLost Rivers Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1760402663
PECOS PAC ID: 7810807427
Enrollment ID: O20161025002060
Entity NameMolina Care Connections, Llc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1407243223
PECOS PAC ID: 5799062881
Enrollment ID: O20180517000247

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. Mary Ellen 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
Mary Ellen Clark, CFNP
240 N Tillotson Ave,
Muncie, IN 47304-3988

Ph: (765) 288-1928		Mary Ellen Clark, CFNP
824 Huntington Ave,
Warren, IN 46792-9277

Ph: (260) 375-2965

Reviews and Comments


Nurse Practitioner Nurses in Warren, IN

Kayla Rose Hoeffel,
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 470 Bennett Dr, Warren, IN 46792
Phone: 260-375-3670    Fax: 260-375-3669
Whitney J. Shafer, NP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 470 Bennett Dr, Warren, IN 46792
Phone: 260-375-3670    Fax: 260-375-3669
Alyssa J Malone, FNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 470 Bennett Dr Ste B, Warren, IN 46792
Phone: 260-375-3670    Fax: 260-375-3669
Amber Mcclain, FNP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 824 Huntington Ave, Warren, IN 46792
Phone: 260-375-2965    
Julie M Towery, NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 824 Huntington Ave # In, Warren, IN 46792
Phone: 260-375-2965    

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.