DR. JESSICA LYNN CLARK (MD) – Dermatology Physician, NPI 1740449719
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,369 DERMATOLOGY in FL
Provider Addresses for DR. JESSICA LYNN CLARK (MD)
600 GRAND PANAMA BLVD STE 104
PANAMA CITY BEACH, FL 324073459
Phone: (850) 238-8511
Fax: (850) 654-3320
Type: Mailing
12469, Emerald Coast Parkway West, Miramar Beach, Walton County, Florida, 32550, United States
MIRAMAR BEACH, FL 325508305
Phone: (850) 654-3376
Fax: (850) 654-3320
Type: Mailing
12139, Panama City Beach Parkway, Panama City Beach, Bay County, Florida, 32407, United States
PANAMA CITY BEACH, FL 324072609
Phone: (850) 654-3376
Fax: (850) 654-3320
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 10 Open Payments records for all available years, with a total value of $366.
Total Amount is formed as General ($366) + Research ($0) + Ownership ($0) = $366.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: ABBVIE INC. ($248).
Total Amount
$366
General + Research + Ownership
Payments
10
Total payment records
General Amount
$366
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $248 |
| Galderma Laboratories, L.P. | $78 |
| Amgen Inc. | $40 |
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: 2016-06-14
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 |
|---|---|---|---|---|
| I20160614001755 | I | Dermatology | 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 32407)
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