EVA CLARK (APRN) – Family Nurse Practitioner, NPI 1669096269
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
24,232 NURSE PRACTITIONER in FL
Provider Addresses for EVA CLARK (APRN)
PO BOX 919771
ORLANDO, FL 328919771
Phone: (239) 278-3600
Type: Mailing
3415 LEE BLVD
LEHIGH ACRES, FL 339711576
Phone: (239) 344-2305
Fax: (239) 368-2044
Type: Location
12370 ROCK RIDGE LN
FORT MYERS, FL 339136763
Phone: (239) 315-2527
Type: Mailing
13770 Plantation Rd # 103
Fort Myers, FL 339124460
Phone: (941) 444-0011
Fax: (603) 952-3900
Type: Location
1265 CREEKSIDE PKWY STE 200
NAPLES, FL 341081954
Phone: (239) 513-1992
Fax: (239) 513-9022
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 29 Open Payments records for all available years, with a total value of $645.
Total Amount is formed as General ($645) + Research ($0) + Ownership ($0) = $645.
Last reported payment date: 2024-11-13 • Largest payer in this snapshot: MAYNE PHARMA COMMERCIAL LLC ($154).
Total Amount
$645
General + Research + Ownership
Payments
29
Total payment records
General Amount
$645
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-13
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2020-08-24
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 |
|---|---|---|---|---|
| I20200824003368 | 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 32891)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | FL | |
| Dermatology, Internal Medicine | FL |
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