MISS DORA K. CLARK (PA-C) – Physician Assistant, NPI 1760559033

MISS DORA K. CLARK (PA-C) is a healthcare provider. based in Fort myers, Florida. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PA00430 (RI). The NPI Number for MISS DORA K. CLARK (PA-C) is 1760559033

Main info

Female
20 Years Of Experience
Accepts Medicare Assignment
Name
MISS DORA K. CLARK (PA-C)
NPI
1760559033
Phone
(239) 931-7342
Address
2234 COLONIAL BLVD
Enumeration Date
29 November 2006
Last Update Date
24 September 2025

Doctor Profile

Medical School Name
DUKE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
2006 (20 years ago)
PAC ID
7214036987
Professional Enrollment ID
I20080512000156
Address ID
RI028932283WE207XXLNXX300
Telehealth
Yes

Contacts

Secure Messaging
referrals@urologicspecialistsofne.direct-ci.net
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness95
Years active:19State licenses:1Other names

773 PHYSICIAN ASSISTANT in RI

Provider Addresses for MISS DORA K. CLARK (PA-C)

  • 2234, Colonial Boulevard, Fort Myers, Lee County, Florida, 33907, United States

    ATTN: PAYER CONTRACTING & RELATIONS

    FORT MYERS, FL 339071412

    Phone: (239) 931-7342

    Fax: (239) 931-7385

    Type: Mailing

  • 176 Cass Ave

    Woonsocket, RI 028954712

    Phone: (401) 828-7110

    Fax: (401) 827-6364

    Type: Location

  • 207 QUAKER LN FL 1

    WEST WARWICK, RI 028932179

    Phone: (401) 828-7110

    Fax: (401) 827-6364

    Type: Mailing

  • 207 QUAKER LN

    WEST WARWICK, RI 028932283

    Phone: (401) 828-7110

    Fax: (401) 825-6029

    Type: Mailing

  • 207, Quaker Lane, Crompton, West Warwick, Kent County, Rhode Island, 02893, United States

    WEST WARWICK, RI 028932283

    Phone: (401) 828-7110

    Fax: (401) 827-6364

    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 $289.

Total Amount is formed as General ($289) + Research ($0) + Ownership ($0) = $289.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: Axonics, Inc. ($113).

Total Amount

$289

General + Research + Ownership

Payments

10

Total payment records

General Amount

$289

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2008-05-12

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
I20080512000156IPhysician AssistantRITBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes191184$0
51798Ultrasound measurement of bladder capacity after voiding9590$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes7670$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes4130$0
99231Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes3324$0
View full utilization report →

Insurance plans in this area (ZIP 33907)

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Reviews

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Frequently asked questions

How is MISS DORA K. CLARK (PA-C) identified in CMS data?
CMS-hosted NPPES data lists MISS DORA K. CLARK (PA-C) with NPI 1760559033.
Is MISS DORA K. CLARK (PA-C) listed as active for patients and plans?
The listing shows MISS DORA K. CLARK (PA-C) as active in the NPI system.
What healthcare role does MISS DORA K. CLARK (PA-C) hold?
Scheduling teams often label MISS DORA K. CLARK (PA-C) under Physician Assistant. Clinical services aligned with this taxonomy classification.
Where should I expect MISS DORA K. CLARK (PA-C) on a map?
Expect Fort Myers, Florida as a primary anchor for MISS DORA K. CLARK (PA-C) unless the record lists multiple sites.
Why does MISS DORA K. CLARK (PA-C) have multiple addresses?
5 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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