ANDREW BURNHAM CLARK (DPM) – Podiatrist, NPI 1679572796

ANDREW BURNHAM CLARK (DPM) is a healthcare provider. based in Maumee, Ohio. specializing in PODIATRY. They hold the professional credentials DPM. They hold a License No. 36.002902 (OH). The NPI Number for ANDREW BURNHAM CLARK (DPM) is 1679572796

Main info

Male
32 Years Of Experience
Accepts Medicare Assignment
Name
ANDREW BURNHAM CLARK (DPM)
NPI
1679572796
Phone
(419) 893-5539
Address
609 FORD ST
Enumeration Date
20 July 2005
Last Update Date
12 February 2010

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4198935539228
Graduation Year
1994 (32 years ago)
PAC ID
2062488448
Group Practice PAC ID
5496720906
Professional Enrollment ID
I20100730000020
Address ID
OH435371947MA609XXSTXX300
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

953 PODIATRY in OH

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Provider Addresses for ANDREW BURNHAM CLARK (DPM)

  • 609, Ford Street, Maumee Historic District, Maumee, Lucas County, Ohio, 43537, United States

    MAUMEE, OH 435371947

    Phone: (419) 893-5539

    Fax: (419) 893-6853

    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 3 Open Payments records for all available years, with a total value of $88.

Total Amount is formed as General ($88) + Research ($0) + Ownership ($0) = $88.

Last reported payment date: 2024-10-21 • Largest payer in this snapshot: DePuy Synthes Sales Inc. ($37).

Total Amount

$88

General + Research + Ownership

Payments

3

Total payment records

General Amount

$88

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-21

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: 2010-07-30

PECOS data refreshed: 2026-06-15

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
I20100730000020IPodiatryOHTBD

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
11721Removal of fingernails or toenails, 6 or more nails1,343367$0
11056Removal of noncancer thickened skin growth, 2-4 growths348133$0
99213Established patient office or other outpatient visit, 20-29 minutes218126$0
J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg12528$0
11055Removal of noncancer thickened skin growth, 1 growth6644$0
View full utilization report →

Insurance plans in this area (ZIP 43537)

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Provider's Procedures

ANDREW BURNHAM CLARK (DPM) performs procedures in PODIATRY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PODIATRYOH11720Removal of tissue from 1 to 5 finger or toe nails1313
PODIATRYOH73630X-ray of foot, minimum of 3 views3024

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: 5496720906View full group profile
NameSpecialtyState
-OH
P O D I A T R YOH
P O D I A T R YOH
P O D I A T R YMI
P O D I A T R YOH
P O D I A T R YOH
P O D I A T R YOH
P O D I A T R YOH
P O D I A T R YOH

Reviews

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Frequently asked questions

How is ANDREW BURNHAM CLARK (DPM) identified in CMS data?
CMS-hosted NPPES data lists ANDREW BURNHAM CLARK (DPM) with NPI 1679572796.
Can I rely on ANDREW BURNHAM CLARK (DPM) being an active provider?
As of the registry snapshot, ANDREW BURNHAM CLARK (DPM) is marked active.
What is ANDREW BURNHAM CLARK (DPM) best known for clinically?
Directory data describes ANDREW BURNHAM CLARK (DPM) with Podiatrist. Clinical services aligned with this taxonomy classification.
Where should I expect ANDREW BURNHAM CLARK (DPM) on a map?
Expect Maumee, Ohio as a primary anchor for ANDREW BURNHAM CLARK (DPM) unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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