DR. MELVIN JEROME CLARK (M.D.) – Ophthalmology Physician, NPI 1093704751
Ophthalmology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
355 OPHTHALMOLOGY in AZ
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Provider Addresses for DR. MELVIN JEROME CLARK (M.D.)
PO BOX 95460
CLEVELAND, OH 441010033
Phone: (602) 581-6076
Fax: (602) 263-1619
Type: Mailing
Phoenix Indian Medical Center, 4212, North 16th Street, Phoenix, Maricopa County, Arizona, 85016, United States
PHOENIX, AZ 850165319
Phone: (602) 263-1200
Fax: (602) 263-1619
Type: Location
PO BOX 31001-0698
PASADENA, CA 911100698
Phone: (602) 263-1200
Type: Mailing
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: 2011-10-24
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20111024000719 | I | Ophthalmology | TX | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 203 | 134 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 64 | 52 | $0 |
| 92014 | Established patient complete exam of visual system | 37 | 34 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 30 | 25 | $0 |
| 76519 | Ultrasound scan to determine eye length and lens power | 24 | 23 | $0 |
Insurance plans in this area (ZIP 44101)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | AZ | |
| Nurse Practitioner | TX | |
| - | AZ | |
| - | AZ | |
| Diagnostic Radiology | AZ | |
| - | AZ | |
| Nurse Practitioner | AZ | |
| Nurse Practitioner | AZ | |
| Certified Registered Nurse Anesthetist (Crna) | AZ | |
| - | AZ |
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