BRIAN M CLARK (O.D.) – Optometrist, NPI 1164686572

BRIAN M CLARK (O.D.) is a healthcare provider. based in Louisville, Kentucky. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 1742DT (KY). The NPI Number for BRIAN M CLARK (O.D.) is 1164686572

Main info

Male
18 Years Of Experience
Accepts Medicare Assignment
Name
BRIAN M CLARK (O.D.)
NPI
1164686572
Phone
(502) 423-8500
Address
7635 SHELBYVILLE RD
Enumeration Date
15 July 2008
Last Update Date
20 October 2010

Doctor Profile

Medical School Name
ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Secondary Phone
5024238500
Graduation Year
2008 (18 years ago)
PAC ID
7113095498
Group Practice PAC ID
6103898895
Professional Enrollment ID
I20081014000583
Address ID
KY402225409LO7635XRDXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:17State licenses:1Digital endpointsOther names

700 OPTOMETRY in KY

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Provider Addresses for BRIAN M CLARK (O.D.)

  • 7635, Shelbyville Road, Norwood, Jefferson County, Kentucky, 40222, United States

    LOUISVILLE, KY 402225409

    Phone: (502) 423-8500

    Fax: (502) 339-0571

    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 26 Open Payments records for all available years, with a total value of $1,128.

Total Amount is formed as General ($1,128) + Research ($0) + Ownership ($0) = $1,128.

Last reported payment date: 2024-12-09 • Largest payer in this snapshot: Johnson & Johnson Vision Care, Inc. ($248).

Total Amount

$1,128

General + Research + Ownership

Payments

26

Total payment records

General Amount

$1,128

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-09

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: 2008-10-14

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
I20081014000583IOptometryKYTBD

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
99214Established patient office or other outpatient visit, 30-39 minutes8686$0
99213Established patient office or other outpatient visit, 20-29 minutes8469$0
92083Exam of visual field with extended testing3636$0
92133Imaging of optic nerve3232$0
92134Imaging of retina2925$0
View full utilization report →

Insurance plans in this area (ZIP 40222)

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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: 6103898895View full group profile
NameSpecialtyState
O P T O M E T R YKY
O P T O M E T R YKY
O P T O M E T R YKY
O P T O M E T R YKY
O P T O M E T R YKY
O P T O M E T R YMO
O P T O M E T R YKY
O P T O M E T R YKY

Reviews

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Frequently asked questions

What identifier follows BRIAN M CLARK (O.D.) across health systems?
The NPI 1164686572 uniquely identifies BRIAN M CLARK (O.D.) in U.S. healthcare data.
Does the public listing show BRIAN M CLARK (O.D.) as active?
BRIAN M CLARK (O.D.)'s NPI record reflects an active status in NPPES.
What services align with BRIAN M CLARK (O.D.)'s listing?
BRIAN M CLARK (O.D.)'s public classification highlights Optometrist. Clinical services aligned with this taxonomy classification.
What city is tied to BRIAN M CLARK (O.D.)?
The directory associates BRIAN M CLARK (O.D.) with Louisville, Kentucky. Check all listed addresses for suites or satellite offices.
Why is information missing for BRIAN M CLARK (O.D.)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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