Mrs Elise Diane Clark, FNP BC in Lima, OH - Medicare Nurse Practitioner

Mrs Elise Diane Clark, FNP BC is a medicare enrolled "Nurse Practitioner" in Lima, Ohio. She went to University Of Toledo College Of Medicine and graduated in 2001 and has 24 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Lima Memorial Professional Corporation, Family Physicians Of Lima Inc and her current practice location is 2875 W Elm St, Lima, Ohio. You can reach out to her office (for appointments etc.) via phone at (419) 991-7805.

Mrs Elise Diane Clark is licensed to practice in Ohio (license number APRN.CNP.06689) 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 1184619595.

Contact Information

	Mrs Elise Diane Clark, FNP BC
	2875 W Elm St, Lima, OH 45805-2510
	(419) 991-7805
	(419) 991-7862

Map and Direction

Provider's Profile

Full Name	Mrs Elise Diane Clark
Gender	Female
Speciality	Nurse Practitioner
Experience	24 Years
Location	2875 W Elm St, Lima, Ohio
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mrs Elise Diane Clark attended and graduated from University Of Toledo College Of Medicine in 2001

NPI Data:

NPI Number: 1184619595
Provider Enumeration Date: 09/13/2005
Last Update Date: 07/01/2025

Medicare PECOS Information:

PECOS PAC ID: 0345274478
Enrollment ID: I20050919000889

Medical Identifiers

Medical identifiers for Mrs Elise Diane Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1184619595	NPI	-	NPPES
500023896	Other	OH	TRAVELERS/RAILROAD MEDICA
9934001	Other	OH	MEDICARE PTAN
2360252	Medicaid	OH

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	APRN.CNP.06689 (Ohio)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Mercy Health-st Rita's Medical Center	Lima, OH	Hospital
Lima Memorial Health System	Lima, OH	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Lima Memorial Professional Corporation	1254232184	190
Family Physicians Of Lima Inc	7719961481	3

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. Mrs Elise Diane Clark allows following entities to bill medicare on her behalf.

Entity Name	Family Physicians Of Lima Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1134112469 PECOS PAC ID: 7719961481 Enrollment ID: O20040618000092

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. Mrs Elise Diane 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
Mrs Elise Diane Clark, FNP BC 2875 W Elm St, Lima, OH 45805-2510 Ph: (419) 991-7805	Mrs Elise Diane Clark, FNP BC 2875 W Elm St, Lima, OH 45805-2510 Ph: (419) 991-7805

Reviews and Comments

Nurse Practitioner Nurses in Lima, OH

Stacy Jo Klass, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1005 Bellefontaine Ave, Suite 100, Lima, OH 45804 Phone: 419-227-5298 Fax: 419-227-5879
Jocelyn Leigh Sherman, CPNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1005 Bellefontaine Ave Ste 245, Lima, OH 45804 Phone: 419-998-8230
Logan Michael Rieman, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 801 Medical Dr Ste A, Lima, OH 45804 Phone: 419-222-6622 Fax: 419-224-0015
Holly A Archer, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2195 Allentown Rd, Lima, OH 45805 Phone: 419-227-2245 Fax: 419-229-1573
Cassandra Baumgartner, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 441 E 8th St, Lima, OH 45804 Phone: 419-221-3072
Jessica A Dailey, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 512 N Cable Rd, Lima, OH 45805 Phone: 419-228-2600 Fax: 419-228-1100
Mrs. Ruth Ann Grothouse, C-NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 750 W High St, Suite 300, Lima, OH 45801 Phone: 419-229-6781 Fax: 419-229-3490

Mrs Elise Diane Clark, FNP BC - Medicare Nurse Practitioner in Lima, OH