Sara Jessanne Lark, FNP
Individual provider Active NPI Family Nurse Practitioner · Raton, NM
NPI 1013545110 · NPPES record last updated Apr 1, 2020
Key facts
- NPI
- 1013545110
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 59889 (NM)
- Practice address
- 203 Hospital Dr
Raton, NM 87740-2012 - Phone
- (575) 445-7771
- Fax
- (575) 445-7742
- NPI assigned
- Apr 1, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.56 of 100
- Quality
- 71.49
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200918000176 | NM | Practitioner - Nurse Practitioner | 6103244470 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59889 | NM | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Miners Colfax Medical Center | Current | Accepting new patients | |
| Miners Colfax Medical Center | Current |
Accepting new patients | |
| Miners Colfax Medical Center | Past | Accepting new patients |
Locations
203 Hospital Dr
Raton, NM 87740
Phone (505) 445-2741
Interoperability endpoints
- stark@mcmc.securechart.com
- https://fhir-myrecord.cerner.com/r4/1762c86e-d105-4afc-a3d1-9e89748c9af3/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 59889 | NM | Yes |
Addresses
Primary practice location
203 Hospital Dr
Raton, NM 87740-2012
Mailing address
203 Hospital Dr
Raton, NM 87740-2012
Phone (575) 445-7771
Other providers in Raton, NM
- Traci Kamp
- La Familia Primary Care
- La Familia Primary Care P C
- Lancer Health Group, LLC
- Claudia Monica Lange
- Laurel Escano Laurel
- Margo Leavitt
- Nikole Lemons
- Michelle Lewis
- Martha C. Lockwood
All providers in Raton, NM · Family Nurse Practitioner in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 1, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.