MR. MICHAEL CLARK (NP) – Nurse Practitioner, NPI 1942653688

MR. MICHAEL CLARK (NP) is a healthcare provider. based in Providence, Rhode Island. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. APRN01380 (RI). The NPI Number for MR. MICHAEL CLARK (NP) is 1942653688

Main info

Male
10 Years Of Experience
Accepts Medicare Assignment
Name
MR. MICHAEL CLARK (NP)
NPI
1942653688
Phone
(401) 444-8467
Address
593 EDDY ST
Enumeration Date
18 July 2016
Last Update Date
24 November 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4014444000
Graduation Year
2016 (10 years ago)
PAC ID
5890066187
Group Practice PAC ID
7214833169
Professional Enrollment ID
I20170804000947
Address ID
RI029034923PR593XXSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness75
Years active:9State licenses:1Digital endpointsOther names

1,476 NURSE PRACTITIONER in RI

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Provider Addresses for MR. MICHAEL CLARK (NP)

  • Rhode Island Hospital, 593, Eddy Street, Downtown, Providence, Providence County, Rhode Island, 02903, United States

    APC SUITE 523

    PROVIDENCE, RI 029034923

    Phone: (401) 444-8467

    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: 2019-06-18

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170804000947INurse PractitionerRITBD
I20190618002841INurse PractitionerMATBD

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
99285Emergency department visit with high level of medical decision making1111$0
View full utilization report →

Insurance plans in this area (ZIP 02903)

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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: 7214833169View full group profile
NameSpecialtyState
Emergency MedicinePA
-RI
-RI
Emergency MedicineRI
Emergency MedicineRI
Emergency MedicineRI
Emergency MedicineRI
Pediatric Medicine, Emergency MedicineRI
Emergency MedicineRI
Emergency MedicineRI

Reviews

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Frequently asked questions

What is the 10-digit NPI for MR. MICHAEL CLARK (NP)?
MR. MICHAEL CLARK (NP) — NPI 1942653688 — is the standard way to identify this listing.
Is MR. MICHAEL CLARK (NP) listed as active for patients and plans?
The listing shows MR. MICHAEL CLARK (NP) as active in the NPI system.
What taxonomy line describes MR. MICHAEL CLARK (NP)?
For research purposes, treat MR. MICHAEL CLARK (NP) as Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
Where is MR. MICHAEL CLARK (NP) based?
MR. MICHAEL CLARK (NP) is tied to Providence, Rhode Island in the data we show; additional addresses may exist on the full record.
Is the information about MR. MICHAEL CLARK (NP) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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