TERRI MARIE CLACK PMHNP-BC
NPI 1487169173
Nurse Practitioner - Psychiatric/Mental Health in Boston, MA

Q: What is Terri Clack's NPI number?

The NPI number for Terri Clack is 1487169173. It was assigned to this individual provider in the NPPES registry on December 5, 2017.

Q: What is Terri Clack's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Terri Clack was last updated on April 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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 December 05, 2017PECOS EnrolledAccepts Medicare Assignment

1 WASHINGTON MALL STE 1045, BOSTON, MA 02108(617) 249-4036(617) 843-9320 Get Directions Write a Review

NPPES record last updated: April 29, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 5, 2022, Jun 30, 2021, Dec 5, 2017 (3 updates tracked since 2017).

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About Terri Marie Clack Pmhnp-bc NPPES

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

TERRI MARIE CLACK PMHNP-BC (NPI 1487169173) is an individual psychiatric/mental health provider in Boston, Massachusetts, licensed in Massachusetts (RN2362195) and active in the NPI registry since December 2017. She is enrolled in Medicare PECOS, maintains a secondary practice location in Weymouth, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1487169173

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameTERRI MARIE CLACKCredential: PMHNP-BC

Location Address1 WASHINGTON MALL STE 1045Boston, MA 02108-2603

Mailing Address1 Washington Mall Ste 1045Boston, MA 02108-2603 · (617) 249-4036 · Fax (617) 843-9320

Phone(617) 249-4036

Fax(617) 843-9320

Sole ProprietorYes

Medical School CMSOtherGraduated 2017

Enumeration DateDecember 5, 2017

Last NPPES UpdateApril 29, 20253 updates tracked since enumeration

NPPES CertifiedApril 29, 2025

✔ NPI 1487169173 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

Licenses✔ Licensed in MA · RN2362195✔ Licensed in GA · RN214255

Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X · License RN214255 (GA)

1 WASHINGTON MALL STE 1045, Boston, MA 02108

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Secondary Practice Location 1

Location 1169 Libbey Industrial PkwyWeymouth, MA 02189-3189 · Phone (781) 551-0999

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Harvard Pilgrim Health Care.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

Terri Marie Clack Pmhnp-bc 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 ID143579086

PECOS Enrollment IDI20221207000920

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02108 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

$97.64 typical visit price

range $63.72 – $189.86

Typical copayment $24.41 (range $15.93 – $47.46)

Most-billed visit code 99203

Established Patient

$111.18 typical visit price

range $21.07 – $155.29

Typical copayment $27.79 (range $5.26 – $38.82)

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.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Terri Clack's NPI number?

The NPI number for Terri Clack is 1487169173. It was assigned to this individual provider in the NPPES registry on December 5, 2017.

Where is Terri Clack located?

Terri Clack practices at 1 Washington Mall Ste 1045, Boston, MA 02108. The listed phone number is (617) 249-4036.

What is Terri Clack's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Terri Clack enrolled in Medicare?

Yes. Terri Clack is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Terri Clack accept?

Health plans from Anthem Blue Cross and Blue Shield and Harvard Pilgrim Health Care list Terri Clack as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Terri Clack was last updated on April 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.