LISA MARIE CLARK (CAA) – Anesthesiologist Assistant, NPI 1215998927
Anesthesiologist Assistant
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
204 ANESTHESIOLOGY ASSISTANT in IN
Provider Addresses for LISA MARIE CLARK (CAA)
151 Pennsylvania Pkwy
Carmel, IN 462801379
Phone: (317) 817-1100
Type: Location
1701 N Senate Blvd
Indianapolis, IN 462021239
Phone: (888) 484-3258
Fax: (317) 944-7051
Type: Location
University Hospitals Cleveland Medical Center, 11100, Euclid Avenue, University Circle, Cleveland, Cuyahoga County, Ohio, 44106, United States
CLEVELAND, OH 441061716
Phone: (216) 844-5583
Type: Mailing
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: 2019-09-18
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 |
|---|---|---|---|---|
| I20190918000703 | I | Anesthesiology Assistant | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 46280)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Pediatric Medicine | NC | |
| U R O L O G Y | IN | |
| Diagnostic Radiology, Interventional Radiology | NY | |
| Nurse Practitioner | IN | |
| P A T H O L O G Y | IN | |
| O T O L A R Y N G O L O G Y | IN | |
| E N D O C R I N O L O G Y | IN | |
| Family Practice, Sports Medicine | IN | |
| Gastroenterology, Internal Medicine | IN | |
| Orthopedic Surgery | MO |
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