DESA MARIAH CLARK APRN
NPI 1215519814
Nurse Practitioner - Family in Fremont, NE

Q: What is Desa Clark's NPI number?

The NPI number for Desa Clark is 1215519814. It was assigned to this individual provider in the NPPES registry on April 22, 2021. The provider is also known as Desa Mariah Eldridge.

Q: What is Desa Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Desa Clark was last updated on July 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 22, 2021PECOS EnrolledAccepts Medicare Assignment

2560 N HEALTHY WAY, FREMONT, NE 68025(402) 941-7245 Get Directions Write a Review

NPPES record last updated: July 7, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 7, 2021, Apr 22, 2021 (2 updates tracked since 2021).

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About Desa Mariah Clark Aprn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DESA MARIAH CLARK APRN (NPI 1215519814) is an individual family provider in Fremont, Nebraska, licensed in Nebraska (113657) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS, is affiliated with Methodist Fremont Health, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1215519814

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameDESA MARIAH CLARKCredential: APRN

Location Address2560 N HEALTHY WAYFremont, NE 68025-2315

Mailing Address605 E Thomsen StFremont, NE 68025-9235 · (402) 317-0797

Phone(402) 941-7245

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateApril 22, 2021

Last NPPES UpdateJuly 7, 20212 updates tracked since enumeration

NPPES CertifiedJuly 7, 2021

✔ NPI 1215519814 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in NE · 113657

Also ListedRegistered NurseTaxonomy 163W00000X · License 64709 (NE)

2560 N HEALTHY WAY, Fremont, NE 68025

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Other Names 1

Former Name (1)Desa Mariah Eldridge

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Nebraska, Medica, Oscar Insurance Company and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Desa Mariah Clark Aprn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2466854591

PECOS Enrollment IDI20210713001295

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

87 services23 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Methodist Fremont Health

Acute Care Hospitals · Fremont, NE

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number280077

Location450 East 23rd StFremont, NE 68025 · Dodge County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 68025 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.20 typical visit price

range $52.69 – $160.21

Typical copayment $20.30 (range $13.17 – $40.05)

Most-billed visit code 99203

Established Patient

$93.55 typical visit price

range $16.90 – $131.25

Typical copayment $23.38 (range $4.22 – $32.81)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CASSANDRA AUGUSTINE

Counselor (Mental Health)