EDITH CLARK (DPM) – Podiatrist, NPI 1770559528

EDITH CLARK (DPM) is a healthcare provider. based in Walker, Michigan. specializing in PODIATRY. They hold the professional credentials DPM. They hold a License No. EC001742 (MI). The NPI Number for EDITH CLARK (DPM) is 1770559528

Main info

Female
33 Years Of Experience
Accepts Medicare Assignment
Name
EDITH CLARK (DPM)
NPI
1770559528
Phone
(616) 453-6329
Address
4310 LEONARD ST NW
Enumeration Date
23 February 2006
Last Update Date
10 June 2010

Doctor Profile

Medical School Name
WILLIAM M. SCHOLL COLLEGE OF PODIATRIC MEDICINE
Secondary Phone
9897716177
Graduation Year
1993 (33 years ago)
PAC ID
2567448483
Group Practice PAC ID
0547246464
Professional Enrollment ID
I20040630000296
Address ID
MI488582961MO211XXSTXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

753 PODIATRY in MI

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Provider Addresses for EDITH CLARK (DPM)

  • 4310, Leonard Street Northwest, Walker, Kent County, Michigan, 49534, United States

    SUITE 103

    WALKER, MI 495348447

    Phone: (616) 453-6329

    Fax: (616) 453-1725

    Type: Mailing

  • Dwyer Avenue, Clare, Clare County, Michigan, 48617, United States

    CLARE, MI 486171002

    Phone: (989) 386-9721

    Type: Location

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 $758.

Total Amount is formed as General ($758) + Research ($0) + Ownership ($0) = $758.

Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Organogenesis Inc. ($644).

Total Amount

$758

General + Research + Ownership

Payments

11

Total payment records

General Amount

$758

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-17

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: 2010-09-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2026-02-28 (103 days ago).

Enrollment records

2

Earliest due date

2026-02-28

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
I20040630000296IPodiatryMITBD
O20100930023092OPhysician - PodiatryMI2026-02-28

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

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
11721Removal of fingernails or toenails, 6 or more nails627207$0
11720Removal of fingernails or toenails, 1-5 nails474159$0
99213Established patient office or other outpatient visit, 20-29 minutes349207$0
99212Established patient office or other outpatient visit, 10-19 minutes10488$0
99203New patient office or other outpatient visit, 30-44 minutes7979$0
View full utilization report →

Insurance plans in this area (ZIP 49534)

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Provider's Procedures

EDITH CLARK (DPM) performs procedures in PODIATRY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PODIATRYMI11042Removal of skin and tissue first 20 sq cm or less12638
PODIATRYMI11056Removal of 2 to 4 thickened skin growths5929
PODIATRYMI73630X-ray of foot, minimum of 3 views3027

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: 0547246464View full group profile
NameSpecialtyState
P O D I A T R YMI

Reviews

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Frequently asked questions

Is EDITH CLARK (DPM) listed with a National Provider Identifier?
Yes — EDITH CLARK (DPM) has NPI 1770559528 on file in the registry.
Is there an active status for EDITH CLARK (DPM)?
For scheduling context, EDITH CLARK (DPM) is shown as active in the registry.
What clinical focus is listed for EDITH CLARK (DPM)?
At a glance, EDITH CLARK (DPM) is tied to Podiatrist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for EDITH CLARK (DPM)?
Travel planning: use Walker, Michigan as the reference point for EDITH CLARK (DPM), then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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