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

Mrs Elise Diane Clark, FNP BC is a medicare enrolled "Nurse Practitioner" in Delphos, Ohio. She went to University Of Toledo College Of Medicine and graduated in 2001 and has 25 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Family Physicians Of Lima Inc, Lima Memorial Professional Corporation and her current practice location is 607 Elida Ave, Delphos, 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
	607 Elida Ave, Delphos, OH 45833-1736
	(419) 991-7805
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Elise Diane Clark
Gender	Female
Speciality	Nurse Practitioner
Experience	25 Years
Location	607 Elida Ave, Delphos, 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: 04/29/2026

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
Lima Memorial Health System	Lima, OH	Hospital
Mercy Health-st Rita's Medical Center	Lima, OH	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Family Physicians Of Lima Inc	7719961481	3
Lima Memorial Professional Corporation	1254232184	168

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 1001 Bellefontaine Ave, Lima, OH 45804-2800 Ph: () -	Mrs Elise Diane Clark, FNP BC 607 Elida Ave, Delphos, OH 45833-1736 Ph: (419) 991-7805

Reviews and Comments

Nurse Practitioner Nurses in Delphos, OH

Stephanie Marie Pierce, MSN, APRN, FNP-C, Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 1500 E 5th St, Delphos, OH 45833 Phone: 419-996-5030 Fax: 419-996-5458
Cassandra Hermiller, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1800 E 5th St, Delphos, OH 45833 Phone: 419-996-5030 Fax: 419-996-5458
Kelly Ann Twigg, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1800 E 5th St, Delphos, OH 45833 Phone: 419-996-5030 Fax: 419-996-5458
Mary E Coplin, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1800 E 5th St, Delphos, OH 45833 Phone: 419-996-5030 Fax: 419-996-5458
Dr. Olivia Katherine Rowland, DNP, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1800 E 5th St, Delphos, OH 45833 Phone: 419-996-5030 Fax: 419-996-5458
Thresa Lynn Grothaus, MS, APRN, CPNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 152 W 2nd St, Delphos, OH 45833 Phone: 567-765-1111 Fax: 833-940-3627

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