Lonnie W Clark, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Woodland Park, CO

Lonnie W Clark, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Woodland Park, Colorado. He graduated from nursing school in 2005 and has 19 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Woodland Park Anesthesia Llc, Diehl Anesthesia and his current practice location is 16420 W Us Highway 24, Woodland Park, Colorado. You can reach out to his office (for appointments etc.) via phone at (806) 790-3928.

Lonnie W Clark is licensed to practice in Texas (license number 690859) and he also participates in the medicare program. He may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1598777450.

Contact Information

Lonnie W Clark, CRNA
16420 W Us Highway 24,
Woodland Park, CO 80863-8760
(806) 790-3928
Not Available



Provider's Profile

Full NameLonnie W Clark
GenderMale
SpecialityCertified Registered Nurse Anesthetist (crna)
Experience19 Years
Location16420 W Us Highway 24, Woodland Park, Colorado
Accepts Medicare AssignmentsMay be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Lonnie W Clark graduated from nursing school in 2005
  NPI Data:
  • NPI Number: 1598777450
  • Provider Enumeration Date: 08/12/2006
  • Last Update Date: 12/09/2020
  Medicare PECOS Information:
  • PECOS PAC ID: 6406861038
  • Enrollment ID: I20081020000188

Medical Identifiers

Medical identifiers for Lonnie W Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1598777450NPI-NPPES
179419001MedicaidTX
200073510AMedicaidOK
90739868MedicaidCO
67349MedicaidTX
147825100MedicaidTX
202004266MedicaidNM
147825101OtherTXFIRSTCARE COMMERCIAL
86092UOtherTXBC/BS
202004266OtherNMPRESBYTERIAN COMMERCIAL
86091UOtherTXHMO BLUE
64851729MedicaidNM

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered 690859 (Texas)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Uchealth Pikes Peak Regional HospitalWoodland park, COHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Woodland Park Anesthesia Llc39717719992
Diehl Anesthesia680019757519

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Lonnie W Clark allows following entities to bill medicare on his behalf.
Entity NameWoodland Park Anesthesia Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1417249996
PECOS PAC ID: 3971771999
Enrollment ID: O20110719000292

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Entity NameDiehl Anesthesia
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1467833897
PECOS PAC ID: 6800197575
Enrollment ID: O20151229000111

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lonnie W Clark is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Lonnie W Clark, CRNA
420 Paisley Dr,
Colorado Springs, CO 80906-8205

Ph: (806) 790-3928
Lonnie W Clark, CRNA
16420 W Us Highway 24,
Woodland Park, CO 80863-8760

Ph: (806) 790-3928

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Nurse Anesthetist, Certified Registered Nurses in Woodland Park, CO

Mr. Brian Thomas Farstad, CRNA
Nurse Anesthetist - CR
Medicare: Medicare Enrolled
Practice Location: 16420 W Us Highway 24, Pikes Peak Regional Hospital, Woodland Park, CO 80863
Phone: 607-207-7233    
Ryan Bezzant, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 16420 W Us Highway 24, Woodland Park, CO 80863
Phone: 719-374-6060    

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