DR. JOHN PHILIP CLARK (MD) – Family Medicine Physician, NPI 1033197983

DR. JOHN PHILIP CLARK (MD) is a healthcare provider. based in Aurora, Colorado. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 0054601 (CO). The NPI Number for DR. JOHN PHILIP CLARK (MD) is 1033197983

Main info

Male
33 Years Of Experience
Accepts Medicare Assignment
Name
DR. JOHN PHILIP CLARK (MD)
NPI
1033197983
Phone
(303) 338-4545
Address
2500 S HAVANA ST
Enumeration Date
1 January 2006
Last Update Date
16 December 2025

Doctor Profile

Medical School Name
OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
3033384545
Graduation Year
1993 (33 years ago)
PAC ID
0244378206
Group Practice PAC ID
1254238454
Professional Enrollment ID
I20150420000539
Address ID
CO802471314DE10350CXXX501

Contacts

SOAP Endpoint
https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateway
SOAP Endpoint
https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience87
Completeness95
Years active:20State licenses:3Other names

2,660 FAMILY PRACTICE in CO

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Provider Addresses for DR. JOHN PHILIP CLARK (MD)

  • Kaiser Permanente, 2500, South Havana Street, Aurora, Arapahoe County, Colorado, 80014, United States

    AURORA, CO 800141618

    Phone: (303) 338-4545

    Type: Mailing

  • Kaiser Permanente Highline Behavioral Health Center, 10350, East Dakota Avenue, Denver, Denver County, Colorado, 80247-1314, United States

    DENVER, CO 802471314

    Phone: (303) 338-4545

    Type: Location

  • 10240 PARK MEADOWS DR

    LONE TREE, CO 801245425

    Phone: (303) 338-4545

    Type: Location

  • 10350 E DAKOTA AVE

    DENVER, CO 802471314

    Phone:

    Type: Mailing

  • 7600 SHAFFER PKWY

    LITTLETON, CO 801273004

    Phone: (303) 338-4545

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-04-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20150420000539IFamily PracticeCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 80014)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1254238454View full group profile
NameSpecialtyState
Nurse PractitionerCO
-CO
Physical Therapist In Private PracticeCO
-CO
-CO
-CO
Cardiovascular Disease (Cardiology)CO
Physical Therapist In Private PracticeCO
Physical Therapist In Private PracticeCO
Family PracticeCO

Reviews

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Frequently asked questions

Does DR. JOHN PHILIP CLARK (MD) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — DR. JOHN PHILIP CLARK (MD) uses 1033197983.
Can I rely on DR. JOHN PHILIP CLARK (MD) being an active provider?
As of the registry snapshot, DR. JOHN PHILIP CLARK (MD) is marked active.
What is DR. JOHN PHILIP CLARK (MD)'s primary classification?
Family Medicine Physician is the headline specialty for DR. JOHN PHILIP CLARK (MD) here. Clinical services aligned with this taxonomy classification.
What address line appears for DR. JOHN PHILIP CLARK (MD)?
DR. JOHN PHILIP CLARK (MD)'s geographic hint is Aurora, Colorado in our summary view.
How many locations tie to this NPI?
5 practice locations appear in the available data.