Terri Marie Clack, PMHNP-BC - Medicare Nurse Practitioner in Boston, MA

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Terri Marie Clack, PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Boston, Massachusetts. Her current practice location is 1 Washington Mall Ste 1045, Boston, Massachusetts. You can reach out to her office (for appointments etc.) via phone at (617) 249-4036.

Terri Marie Clack is licensed to practice in Massachusetts (license number RN2362195) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1487169173.

Contact Information

Terri Marie Clack, PMHNP-BC
1 Washington Mall Ste 1045,
Boston, MA 02108-2603
(617) 249-4036
(617) 843-9320

Map and Direction




Provider's Profile

Full NameTerri Marie Clack
GenderFemale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location1 Washington Mall Ste 1045, Boston, Massachusetts
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1487169173
  • Provider Enumeration Date: 12/05/2017
  • Last Update Date: 04/29/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 0143579086
  • Enrollment ID: I20180825000126

Medical Identifiers

Medical identifiers for Terri Marie Clack such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1487169173NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP2300XNurse Practitioner - Primary Care RN214255 (Georgia)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health RN2362195 (Massachusetts)Primary
363LP0808XNurse Practitioner - Psychiatric/mental Health RN214255 (Georgia)Secondary

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. Terri Marie Clack allows following entities to bill medicare on her behalf.
Entity NameHmv Diagnostics Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1043460744
PECOS PAC ID: 8123172020
Enrollment ID: O20100224000575
Entity NameUnited Psychology Center Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1063704542
PECOS PAC ID: 0648424796
Enrollment ID: O20130125000418
Entity NameGeorgia Palliative Care Services Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1295290450
PECOS PAC ID: 9537492137
Enrollment ID: O20190613002834

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. Terri Marie Clack 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
Terri Marie Clack, PMHNP-BC
1 Washington Mall Ste 1045,
Boston, MA 02108-2603

Ph: (617) 249-4036		Terri Marie Clack, PMHNP-BC
1 Washington Mall Ste 1045,
Boston, MA 02108-2603

Ph: (617) 249-4036

Reviews and Comments


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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).

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