DR. ELIZABETH PENICK CLARK (D.O., MPH & TM) – Family Medicine Physician, NPI 1134195993
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
83 OSTEOPATHIC MANIPULATIVE MEDICINE in CO
Provider Addresses for DR. ELIZABETH PENICK CLARK (D.O., MPH & TM)
1015 W 39TH 1/2 ST
AUSTIN, TX 787564005
Phone: (512) 371-7478
Fax: (512) 371-3861
Type: Mailing
9250 E COSTILLA AVE STE 540
GREENWOOD VILLAGE, CO 801123648
Phone: (720) 644-9355
Type: Mailing
12230 LIONESS WAY
PARKER, CO 801345603
Phone: (720) 644-9355
Type: Location
Crownpoint Drive, San Antonio, Bexar County, Texas, 78233, United States
SAN ANTONIO, TX 78233
Phone: (210) 881-0630
Fax: (210) 641-1608
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: 2024-01-04
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 |
|---|---|---|---|---|
| I20240104002405 | I | Osteopathic Manipulative Medicine | 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 78756)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | CO | |
| - | CO | |
| Hospice/Palliative Care, Osteopathic Manipulative Medicine | CA | |
| - | CO | |
| Physical Medicine And Rehabilitation | CO | |
| Internal Medicine | CO | |
| Family Practice | CO | |
| Internal Medicine | CO | |
| Physician Assistant | NC | |
| Nurse Practitioner | CO |
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