MATTHEW M. CLARK (PHD) – Clinical Psychologist, NPI 1366420895

MATTHEW M. CLARK (PHD) is a healthcare provider. based in Rochester, Minnesota. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. LP4101 (MN). The NPI Number for MATTHEW M. CLARK (PHD) is 1366420895

Main info

Male
40 Years Of Experience
Accepts Medicare Assignment
Name
MATTHEW M. CLARK (PHD)
NPI
1366420895
Phone
(507) 284-2511
Address
200 1ST ST SW
Enumeration Date
5 January 2006
Last Update Date
24 August 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5072842511
Graduation Year
1986 (40 years ago)
PAC ID
0941345979
Group Practice PAC ID
6507778255
Professional Enrollment ID
I20100302000749
Address ID
MN559050001RO200XXSWXX400
Telehealth
Yes

Contacts

Secure Messaging
mclark132441@ehrdirect.mayoclinicmsg.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

1,110 CLINICAL PSYCHOLOGIST in MN

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Provider Addresses for MATTHEW M. CLARK (PHD)

  • 1st Street Southwest, Rochester, Olmsted County, Minnesota, 55903, United States

    ROCHESTER, MN 559050001

    Phone: (507) 284-2511

    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)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2010-03-02

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
I20100302000749IClinical PsychologistMNTBD

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
96165Treatment of behavior impacting health in group setting, each additional 30 minutes20329$0
96164Treatment of behavior impacting health in group setting, initial 30 minutes11429$0
96158Treatment of behavior impacting health, initial 30 minutes2520$0
96156Assessment of health behavior1414$0
View full utilization report →

Insurance plans in this area (ZIP 55905)

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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: 6507778255View full group profile

Reviews

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Frequently asked questions

Where can patients find MATTHEW M. CLARK (PHD)'s NPI?
You can confirm MATTHEW M. CLARK (PHD) with NPI 1366420895; it appears in the national provider directory.
Does this profile mean MATTHEW M. CLARK (PHD) is currently active?
Yes — MATTHEW M. CLARK (PHD) appears active in the national provider directory.
What kind of provider is MATTHEW M. CLARK (PHD)?
The page reflects Clinical Psychologist for MATTHEW M. CLARK (PHD). Clinical services aligned with this taxonomy classification.
Where does public data place MATTHEW M. CLARK (PHD)?
The snapshot lists Rochester, Minnesota for MATTHEW M. CLARK (PHD); download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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