Teresa M Clark, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

TP006932B Issued in PA

Practice address

340 Montage Mountain Rd
Moosic, PA 18507-1782

Phone

(570) 346-3686

Fax

(570) 558-6838

NPI assigned

Aug 30, 2006

Last updated

Sep 2, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Comprehensive Pain Management Specialists , LLCGroup PAC ID 4880875426, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wilkes-Barre General Hospital Hospital, Wilkes-Barre, PA, CCN 390137

Merit-based Incentive Payment System (MIPS)

Final score

79.48 of 100Reported as group

Quality

56.58

Improvement activities

40

Cost

76.9

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tclark@comprehensivepaindocs.medentdirect.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Comprehensive Pain Management Specialists , LLC

  • Interventional Pain Medicine Physician
  • Wilkes Barre, PA
  • NPI 1841591211
  Medicare reassignment Care Compare group NPD
• Meditelecare of Pennsylvania LLC

  • Clinical Psychologist
  • Harrisburg, PA
  • NPI 1396351847

  Nurse Practitioner

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Wilkes Barre Hospital Company LLC

  dba Wilkes Barre General Hospital

  • Clinic/Center
  • Wilkes Barre, PA
  • NPI 1053554378

  Hospital

  Care Compare affiliation
• Wilkes Barre Hospital Company LLC

  dba Wilkes Barre General Hospital

  • General Acute Care Hospital
  • Wilkes Barre, PA
  • NPI 1255585303
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283385600000",
    "number": "1306956172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 MONTAGE MOUNTAIN RD",
            "city": "MOOSIC",
            "state": "PA",
            "postal_code": "185071782",
            "telephone_number": "570-346-3686",
            "fax_number": "570-558-6838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 MONTAGE MOUNTAIN RD",
            "city": "MOOSIC",
            "state": "PA",
            "postal_code": "185071782",
            "telephone_number": "570-346-3686",
            "fax_number": "570-558-6838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "TERESA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2010-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "TP006932B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ethan Calafut
• Mary E. Callahan, RN MSM CRNP
• CD Glenmaura LLC
• Stacy Lynn Cella, PHARMD
• Alicia L. Clark, DPT
• Coh Mental Health Wellness LLC (Coh Mental Health Wellness)
• Coleman Counseling and Wellness LLC Dba Coleman Ocd & Anxiety Therapy
• Chelsea Taylor Collins, LSW
• Comprehensive Care Clinic
• Amanda Leigh Craven, CRNP

• Nurse Practitioner in Moosic, PA
• Providers in Moosic, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.