SUSAN MARIE CLARK (PMHNP-BC) – Psychiatric/Mental Health Nurse Practitioner, NPI 1376161950
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
24,232 NURSE PRACTITIONER in FL
Provider Addresses for SUSAN MARIE CLARK (PMHNP-BC)
674 CORAL WAY
WINTER SPRINGS, FL 327083127
Phone: (334) 220-2985
Type: Location
674 Coral Way
Winter Springs, FL 327083127
Phone: (334) 220-2985
Type: Location
722 TRADE WAY
SANFORD, FL 327713277
Phone: (407) 863-4001
Fax: (407) 915-4387
Type: Location
300 TREEMONTE DR
ORANGE CITY, FL 327637977
Phone: (800) 614-4124
Fax: (888) 217-4124
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $228.
Total Amount is formed as General ($228) + Research ($0) + Ownership ($0) = $228.
Last reported payment date: 2024-05-30 • Largest payer in this snapshot: Axsome Therapeutics, Inc. ($116).
Total Amount
$228
General + Research + Ownership
Payments
2
Total payment records
General Amount
$228
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-05-30
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Axsome Therapeutics, Inc. | $116 |
| Neurocrine BioSciences Inc. | $112 |
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: 2020-10-02
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 |
|---|---|---|---|---|
| I20201002002888 | I | Nurse Practitioner | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32708)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P S Y C H I A T R Y | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| Clinical Social Worker | FL | |
| P S Y C H I A T R Y | PR | |
| - | FL | |
| - | FL | |
| Mental Health Counselor | FL | |
| - | FL | |
| - | FL |
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