Mary Ellen Clark, CFNP - Medicare Nurse Practitioner in Mountain Home Afb, ID

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Mary Ellen Clark, CFNP is a medicare enrolled "Nurse Practitioner - Primary Care" in Mountain Home Afb, Idaho. She graduated from nursing school in 2012 and has 12 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 90 Hope Dr Bldg 6000, Mountain Home Afb, Idaho. You can reach out to her office (for appointments etc.) via phone at (208) 828-7635.

Mary Ellen Clark is licensed to practice in Idaho (license number 66049) 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
90 Hope Dr Bldg 6000,
Mountain Home Afb, ID 83648-1062
(208) 828-7635
Not Available

Map and Direction




Provider's Profile

Full NameMary Ellen Clark
GenderFemale
SpecialityNurse Practitioner
Experience12 Years
Location90 Hope Dr Bldg 6000, Mountain Home Afb, Idaho
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: 07/16/2021
  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 201250210NP (Oregon)Secondary
363LP2300XNurse Practitioner - Primary Care 66049 (Idaho)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Lost Rivers Medical CenterArco, IDHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Lost Rivers Medical Center781080742712

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
Entity NameDoctors House Calls Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1982185260
PECOS PAC ID: 5799024337
Enrollment ID: O20190227000148

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
Po Box 26666,
Albuquerque, NM 87125-6666

Ph: () -		Mary Ellen Clark, CFNP
90 Hope Dr Bldg 6000,
Mountain Home Afb, ID 83648-1062

Ph: (208) 828-7635

Reviews and Comments


Nurse Practitioner Nurses in Mountain Home Afb, ID

Daniel Robert Burke, RN, FNP-C
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 90 Hope Dr, Mountain Home Afb, ID 83648
Phone: 208-828-7281    
Kristin Kepler, RN, DNP, WHNP-BC
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648
Phone: 208-828-7572    
Kristine Marie Hackett, WHNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 90 Hope Dr, 366th Mdg/surgical Operations Squadron, Mountain Home Afb, ID 83648
Phone: 208-828-7534    
Linda J Hensley, NURSE PRACTITIONER
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648
Phone: 208-828-7655    

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.