DR. SAMUEL DAMAIN PEPETO CLARKE (MD) – Family Medicine Physician, NPI 1013529304

DR. SAMUEL DAMAIN PEPETO CLARKE (MD) is a healthcare provider. based in Ormond beach, Florida. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. ME162657 (FL). The NPI Number for DR. SAMUEL DAMAIN PEPETO CLARKE (MD) is 1013529304

Main info

Male
13 Years Of Experience
Accepts Medicare Assignment
Name
DR. SAMUEL DAMAIN PEPETO CLARKE (MD)
NPI
1013529304
Phone
(386) 317-8620
Address
300 CLYDE MORRIS BLVD STE A
Enumeration Date
19 August 2020
Last Update Date
6 January 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3863178620
Graduation Year
2013 (13 years ago)
PAC ID
9436596806
Group Practice PAC ID
9436201233
Professional Enrollment ID
I20240320003187
Address ID
FL321745909OR300XXBLVD401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:5State licenses:1Digital endpointsOther names

6,722 FAMILY PRACTICE in FL

Provider Addresses for DR. SAMUEL DAMAIN PEPETO CLARKE (MD)

  • 300 CLYDE MORRIS BLVD STE A

    ORMOND BEACH, FL 321745909

    Phone: (386) 317-8620

    Fax: (386) 317-8625

    Type: Mailing

  • 7031 SW 62ND AVE

    SOUTH MIAMI, FL 331434701

    Phone: (305) 284-7761

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 19 Open Payments records for all available years, with a total value of $575.

Total Amount is formed as General ($575) + Research ($0) + Ownership ($0) = $575.

Last reported payment date: 2024-10-17 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($125).

Total Amount

$575

General + Research + Ownership

Payments

19

Total payment records

General Amount

$575

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-17

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2024-03-20

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
I20240320003187IFamily PracticeFLTBD

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 32174)

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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: 9436201233View full group profile

Reviews

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Frequently asked questions

What is DR. SAMUEL DAMAIN PEPETO CLARKE (MD)'s NPI number?
DR. SAMUEL DAMAIN PEPETO CLARKE (MD)'s NPI is 1013529304 — the number used across U.S. healthcare to identify this provider.
Is there an active status for DR. SAMUEL DAMAIN PEPETO CLARKE (MD)?
For scheduling context, DR. SAMUEL DAMAIN PEPETO CLARKE (MD) is shown as active in the registry.
What area of care is associated with DR. SAMUEL DAMAIN PEPETO CLARKE (MD)?
DR. SAMUEL DAMAIN PEPETO CLARKE (MD)'s record emphasizes Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where in Florida is DR. SAMUEL DAMAIN PEPETO CLARKE (MD) registered?
Use Ormond Beach, Florida as the headline location for DR. SAMUEL DAMAIN PEPETO CLARKE (MD) here.
Does DR. SAMUEL DAMAIN PEPETO CLARKE (MD) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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