MRS. BRANTRIESA CLARK (PA) – Physician Assistant, NPI 1659883684
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,431 PHYSICIAN ASSISTANT in GA
Provider Addresses for MRS. BRANTRIESA CLARK (PA)
1829 Lawrenceville Hwy
Decatur, GA 300335728
Phone: (404) 292-8335
Type: Location
5447 Dividend Dr
Lithonia, GA 300588412
Phone: (770) 322-8881
Type: Location
60 LOTUS LN
COVINGTON, GA 300161978
Phone: (404) 992-9254
Type: Mailing
1829 LAWRENCEVILLE HWY
DECATUR, GA 300335728
Phone: (404) 292-8335
Type: Location
4181 HOSPITAL DR NE STE 205
COVINGTON, GA 300142541
Phone: (678) 342-8677
Type: Location
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: 2020-03-03
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 |
|---|---|---|---|---|
| I20200303001744 | I | Physician Assistant | GA | 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 |
|---|---|---|---|---|
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 80 | 40 | $0 |
| 87426 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | 62 | 61 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 48 | 43 | $0 |
| 87400 | Detection test by immunoassay technique for influenza virus | 38 | 19 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 37 | 37 | $0 |
Insurance plans in this area (ZIP 30033)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | TN | |
| - | GA | |
| - | GA | |
| - | GA | |
| Nurse Practitioner | GA | |
| Internal Medicine | OH | |
| Nurse Practitioner | GA | |
| Advanced Heart Failure And Transplant Cardiology, Cardiovascular Disease (Cardiology) | GA | |
| Cardiovascular Disease (Cardiology) | GA | |
| - | GA |
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