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

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: October 25, 2026.

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

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
Open in Google Maps ↗

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 Harvard Pilgrim Health Care, Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Terri Clack reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

United Psychology Center, LLC
926 mi
Psychiatry
2900 CHAMBLEE TUCKER RD BLDG 16
Atlanta, GA 30341
  • Reassigned Medicare billing, Georgia enrollment
  • 33 clinicians in this Medicare group
NPI 1063704542 (770) 939-1288
Hmv Diagnostics
1,176 mi
Clinic/Center
5304 MILE STRETCH DR
Holiday, FL 34690
  • Reassigned Medicare billing, Georgia enrollment
  • 7 clinicians in this Medicare group
NPI 1043460744 (727) 940-5908

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

Which organizations bill Medicare for Terri Clack's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Terri Clack reassigns Medicare benefits to 2 organizations: United Psychology Center, LLC (Atlanta, GA) and Hmv Diagnostics (Holiday, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Terri Clack's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Terri Clack accept?

Health plans from Harvard Pilgrim Health Care and Oscar Health 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 18 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.