MICHELLE W CLARK (PHYSICIAN ASSISTANT) – Physician Assistant, NPI 1881226462
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
13,243 PHYSICIAN ASSISTANT in NY
Provider Addresses for MICHELLE W CLARK (PHYSICIAN ASSISTANT)
5464 BULL CREEK DR
DUBLIN, OH 430166178
Phone: (440) 320-2597
Type: Mailing
773 SHADYLAWN DR
AMHERST, OH 440011542
Phone: (440) 988-4605
Type: Mailing
1275 YORK AVE
NEW YORK, NY 100656007
Phone: (212) 639-2000
Type: Location
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: 2025-06-24
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 |
|---|---|---|---|---|
| I20200713003282 | I | Physician Assistant | NY | TBD |
| I20250624000879 | I | Physician Assistant | CO | 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 43016)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | CO | |
| H E M A T O L O G Y/ O N C O L O G Y | CO | |
| Physician Assistant | CO | |
| Medical Oncology | CO | |
| Radiation Oncology | CO | |
| Nurse Practitioner | CO | |
| H E M A T O L O G Y/ O N C O L O G Y | CO | |
| Medical Oncology, Hematology/Oncology | CO | |
| - | CO | |
| Internal Medicine, Medical Oncology | CO |
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