SAMANTHA CLARK (OD) – Optometrist, NPI 1033763016
Optometrist
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
1,126 OPTOMETRY in IN
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Provider Addresses for SAMANTHA CLARK (OD)
397, Valparaiso, Santa Marta, Ingeniero Budge, Partido de Lomas de Zamora, Buenos Aires, 1839, Argentina
VALPARAISO, IN 463858830
Phone:
Type: Mailing
Oak Drive, Manadon, Crownhill, Plymouth, South West England, England, PL6 5FR, United Kingdom
PLYMOUTH, IN 465633403
Phone: (574) 935-3937
Fax: (574) 936-4942
Type: Location
2878 MILLER DR
PLYMOUTH, IN 465638094
Phone: (574) 935-3937
Fax: (574) 936-4942
Type: Location
111 E 4TH ST STE 440
ALTON, IL 620026206
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 11 Open Payments records for all available years, with a total value of $262.
Total Amount is formed as General ($262) + Research ($0) + Ownership ($0) = $262.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($206).
Total Amount
$262
General + Research + Ownership
Payments
11
Total payment records
General Amount
$262
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 |
|---|---|
| Bausch & Lomb Americas Inc. | $206 |
| Alcon Vision LLC | $56 |
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: 2019-08-12
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190812003048 | I | Optometry | IN | 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 |
|---|---|---|---|---|
| 92014 | Established patient complete exam of visual system | 23 | 23 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 22 | 12 | $0 |
Insurance plans in this area (ZIP 46385)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | IN | |
| O P T O M E T R Y | IN | |
| O P T O M E T R Y | IN | |
| O P T O M E T R Y | IN | |
| O P T O M E T R Y | IN | |
| O P T O M E T R Y | IN | |
| O P T O M E T R Y | IN | |
| O P T O M E T R Y | IN | |
| O P T O M E T R Y | KY | |
| O P T O M E T R Y | VA |
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