KATIE CLARK (OD) – Optometrist, NPI 1164092383
Optometrist
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
879 OPTOMETRY in MN
Provider Addresses for KATIE CLARK (OD)
3835 W OLD SHAKOPEE RD STE 200
BLOOMINGTON, MN 554313570
Phone: (651) 461-0151
Type: Location
8639 COUNTY ROAD 16 SE
DELANO, MN 553288134
Phone: (612) 709-8661
Type: Mailing
3408 BARDSTOWN RD
LOUISVILLE, KY 402184608
Phone: (502) 912-9884
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $64.
Total Amount is formed as General ($64) + Research ($0) + Ownership ($0) = $64.
Last reported payment date: 2024-12-06 • Largest payer in this snapshot: ANI Pharmaceuticals, Inc. ($34).
Total Amount
$64
General + Research + Ownership
Payments
2
Total payment records
General Amount
$64
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ANI Pharmaceuticals, Inc. | $34 |
| Alcon Vision LLC | $30 |
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: 2025-01-08
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20210810002741 | I | Optometry | MN | TBD |
| I20250108003597 | I | Optometry | KY | 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 55431)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | SC | |
| - | NY | |
| O P T O M E T R Y | KY | |
| O P T O M E T R Y | IN | |
| - | KY | |
| O P T O M E T R Y | AE | |
| - | IN | |
| O P T O M E T R Y | KY | |
| O P T O M E T R Y | TX | |
| O P T O M E T R Y | OH |
Reviews
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