TODD CLARK (MEDICAL DOCTOR) – Emergency Medicine Physician, NPI 1073504767
Emergency Medicine Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for TODD CLARK (MEDICAL DOCTOR)
Dempster & Luther, 1775, West Dempster Street, Park Ridge, Cook County, Illinois, 60068, United States
1 WEST
PARK RIDGE, IL 600681143
Phone: (847) 723-5150
Fax: (847) 723-2083
Type: Mailing
29373 NETWORK PL
CHICAGO, IL 606731143
Phone: (847) 390-5900
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $25.
Total Amount is formed as General ($25) + Research ($0) + Ownership ($0) = $25.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: Collegium Pharmaceutical, Inc. ($25).
Total Amount
$25
General + Research + Ownership
Payments
1
Total payment records
General Amount
$25
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 |
|---|---|
| Collegium Pharmaceutical, Inc. | $25 |
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: 2009-10-21
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 |
|---|---|---|---|---|
| I20091021000159 | I | Emergency Medicine | IL | 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 |
|---|---|---|---|---|
| 99284 | Emergency department visit with moderate level of medical decision making | 95 | 95 | $0 |
| 99285 | Emergency department visit with high level of medical decision making | 22 | 22 | $0 |
| 99283 | Emergency department visit with low level of medical decision making | 16 | 16 | $0 |
Insurance plans in this area (ZIP 60068)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Cardiovascular Disease (Cardiology), Internal Medicine | IL | |
| Nephrology, Internal Medicine | IL | |
| A N E S T H E S I O L O G Y | IL | |
| Internal Medicine | IL | |
| Clinical Social Worker | IL | |
| - | MN | |
| - | IL | |
| - | IL | |
| Hospitalist, Internal Medicine | IL | |
| Physician Assistant | NC |
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