DR. GARRETT CLARK (D.O.) – Internal Medicine Physician, NPI 1063677524
Internal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. GARRETT CLARK (D.O.)
LECOM Medical Fitness & Wellness Center, 5401, Peach Street, Kearsarge, Millcreek Township, Erie County, Pennsylvania, 16509, United States
SUITE 3500
ERIE, PA 165092601
Phone: (814) 868-2179
Fax: (814) 868-2346
Type: Location
LECOM Bayfront, 1, Lecom Place, Frontier, Erie, Erie County, Pennsylvania, 16505, United States
ERIE, PA 165052571
Phone:
Fax: (814) 868-2522
Type: Mailing
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 $60.
Total Amount is formed as General ($60) + Research ($0) + Ownership ($0) = $60.
Last reported payment date: 2024-02-29 • Largest payer in this snapshot: Otsuka Pharmaceutical Development & Commercialization, Inc. ($43).
Total Amount
$60
General + Research + Ownership
Payments
2
Total payment records
General Amount
$60
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-02-29
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Otsuka Pharmaceutical Development & Commercialization, Inc. | $43 |
| Novo Nordisk Inc | $17 |
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: 2009-03-18
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 |
|---|---|---|---|---|
| I20090318000149 | I | Internal Medicine | PA | 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 16509)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Colorectal Surgery (Proctology) | PA | |
| - | WV | |
| Physician Assistant | PA | |
| - | PA | |
| Internal Medicine, Addiction Medicine | PA | |
| - | PA | |
| - | PA | |
| - | PA | |
| Vascular Surgery | PA | |
| P O D I A T R Y | KY |
Reviews
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