DR. STACY ANN CLARK (OD) – Optometrist, NPI 1912016494

DR. STACY ANN CLARK (OD) is a healthcare provider. based in Salina, Kansas. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. KS13703 (KS). The NPI Number for DR. STACY ANN CLARK (OD) is 1912016494

Main info

Female
34 Years Of Experience
Accepts Medicare Assignment
Name
DR. STACY ANN CLARK (OD)
NPI
1912016494
Phone
(785) 825-4679
Address
1601 E IRON AVE
Enumeration Date
29 August 2006
Last Update Date
22 June 2008

Doctor Profile

Medical School Name
UNIVERSITY OF MISSOURI ST LOUIS - SCHOOL OF OPTOMETRY
Secondary Phone
7858254679
Graduation Year
1992 (34 years ago)
PAC ID
1254374440
Group Practice PAC ID
7416840392
Professional Enrollment ID
I20050608000805
Address ID
KS674013237SA1601XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

532 OPTOMETRY in KS

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Provider Addresses for DR. STACY ANN CLARK (OD)

  • 1601, East Iron Avenue, Salina, Saline County, Kansas, 67401, United States

    SALINA, KS 674013237

    Phone: (785) 825-4679

    Fax: (785) 825-5898

    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 13 Open Payments records for all available years, with a total value of $346.

Total Amount is formed as General ($346) + Research ($0) + Ownership ($0) = $346.

Last reported payment date: 2024-12-24 • Largest payer in this snapshot: Genentech USA, Inc. ($129).

Total Amount

$346

General + Research + Ownership

Payments

13

Total payment records

General Amount

$346

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-24

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2005-06-08

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050608000805IOptometryKSTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92014Established patient complete exam of visual system244232$0
92250Photography of the retina194173$0
99213Established patient office or other outpatient visit, 20-29 minutes144101$0
92134Imaging of retina8369$0
99214Established patient office or other outpatient visit, 30-39 minutes5148$0
View full utilization report →

Insurance plans in this area (ZIP 67401)

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Provider's Procedures

DR. STACY ANN CLARK (OD) performs procedures in OPTOMETRY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OPTOMETRYKS92012Eye and medical examination for diagnosis and treatment, established patient4037
OPTOMETRYKS92083Measurement of field of vision during daylight conditions2926
OPTOMETRYKS92134Diagnostic imaging of retina3630

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7416840392View full group profile
NameSpecialtyState
O P T O M E T R YKS
O P T O M E T R YKS
O P T O M E T R YKS

Reviews

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Frequently asked questions

Is there an official ID for DR. STACY ANN CLARK (OD) in U.S. healthcare records?
The official identifier for DR. STACY ANN CLARK (OD) is NPI 1912016494.
Is there an active status for DR. STACY ANN CLARK (OD)?
For scheduling context, DR. STACY ANN CLARK (OD) is shown as active in the registry.
What area of care is associated with DR. STACY ANN CLARK (OD)?
DR. STACY ANN CLARK (OD)'s record emphasizes Optometrist. Clinical services aligned with this taxonomy classification.
Where in Kansas is DR. STACY ANN CLARK (OD) registered?
Use Salina, Kansas as the headline location for DR. STACY ANN CLARK (OD) here.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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