DR. GORDON BLAKE CLARK (MD) – Obesity Medicine (Obstetrics & Gynecology) Physician, NPI 1417937145
Obesity Medicine (Obstetrics & Gynecology) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
382 OBSTETRICS/GYNECOLOGY in KS
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Provider Addresses for DR. GORDON BLAKE CLARK (MD)
21624, Midland Drive, Monticello Farms, Zarah, Shawnee, Johnson County, Kansas, 66218, United States
SHAWNEE, KS 662189064
Phone: (913) 643-0075
Fax: (913) 643-0077
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 15 Open Payments records for all available years, with a total value of $2,202.
Total Amount is formed as General ($2,202) + Research ($0) + Ownership ($0) = $2,202.
Last reported payment date: 2024-12-13 • Largest payer in this snapshot: Sumitomo Pharma America, Inc. ($1,960).
Total Amount
$2,202
General + Research + Ownership
Payments
15
Total payment records
General Amount
$2,202
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Sumitomo Pharma America, Inc. | $1,960 |
| Amgen Inc. | $127 |
| Janssen Biotech, Inc. | $42 |
| PFIZER INC. | $22 |
| Lilly USA, LLC | $19 |
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: 2011-12-13
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 |
|---|---|---|---|---|
| I20111213000326 | I | Obstetrics/Gynecology | KS | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 134 | 30 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 52 | 12 | $0 |
Insurance plans in this area (ZIP 66218)
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