JACK CLARK (D.O.) – Rheumatology Physician, NPI 1073563847
Rheumatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for JACK CLARK (D.O.)
2675 WINKLER AVE FL 2
FORT MYERS, FL 339019342
Phone: (877) 856-3774
Fax: (239) 599-2612
Type: Mailing
1528, Del Prado Boulevard South, Cape Coral, Lee County, Florida, 33990, United States
CAPE CORAL, FL 339903798
Phone: (239) 458-3338
Fax: (239) 458-0666
Type: Location
Hancock Bridge Parkway, North Star Yacht Club, North Fort Myers, Lee County, Florida, 33903, United States
NORTH FORT MYERS, FL 339037099
Phone: (877) 856-3774
Type: Mailing
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: 2010-04-05
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100405000101 | I | Rheumatology | FL | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 853 | 375 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 219 | 139 | $0 |
| 86140 | Measurement c-reactive protein for detection of infection or inflammation | 193 | 118 | $0 |
| 80053 | Blood test, comprehensive group of blood chemicals | 172 | 115 | $0 |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 171 | 114 | $0 |
Insurance plans in this area (ZIP 33901)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| RHEUMATOLOGY | FL | 20610 | Aspiration and/or injection of large joint or joint capsule | 219 | 115 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | FL | |
| Nurse Practitioner | FL | |
| Family Practice | FL | |
| - | FL | |
| - | FL | |
| - | FL | |
| - | FL | |
| Nurse Practitioner | FL | |
| - | FL | |
| Cardiovascular Disease (Cardiology), Internal Medicine | FL |
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