SUMMER CLARK (M.D.) – MOHS-Micrographic Surgery Physician, NPI 1154736643

SUMMER CLARK (M.D.) is a healthcare provider. based in Amarillo, Texas. specializing in DERMATOLOGY. They hold the professional credentials M.D.. They hold a License No. S1580 (TX). The NPI Number for SUMMER CLARK (M.D.) is 1154736643

Main info

Female
12 Years Of Experience
Accepts Medicare Assignment
Name
SUMMER CLARK (M.D.)
NPI
1154736643
Phone
(806) 354-4900
Address
1611 WALLACE BLVD
Enumeration Date
24 June 2014
Last Update Date
4 June 2019

Doctor Profile

Medical School Name
UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
Secondary Phone
-
Graduation Year
2014 (12 years ago)
PAC ID
8123248887
Group Practice PAC ID
3678579232
Professional Enrollment ID
I20190819002941
Address ID
TX791061799AM1611XBLVD300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:11State licenses:1Digital endpointsOther names

1,284 DERMATOLOGY in TX

Provider Addresses for SUMMER CLARK (M.D.)

  • 1611 WALLACE BLVD

    AMARILLO, TX 791061799

    Phone: (806) 354-4900

    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 21 Open Payments records for all available years, with a total value of $271.

Total Amount is formed as General ($271) + Research ($0) + Ownership ($0) = $271.

Last reported payment date: 2024-12-12 • Largest payer in this snapshot: Bioventus LLC ($132).

Total Amount

$271

General + Research + Ownership

Payments

21

Total payment records

General Amount

$271

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-12

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: 2019-08-19

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190819002941IDermatologyTXTBD

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
99213Established patient office or other outpatient visit, 20-29 minutes606431$0
17003Destruction of precancer skin growth, 2-14 growths595123$0
11102Biopsy of related skin growth, first growth552420$0
17311Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks541337$0
11103Biopsy of related skin growth, each additional growth407209$0
View full utilization report →

Insurance plans in this area (ZIP 79106)

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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: 3678579232View full group profile
NameSpecialtyState
Nurse PractitionerTX
D E R M A T O L O G YTX
Plastic And Reconstructive SurgeryTX
Ophthalmology, Plastic And Reconstructive SurgeryTX

Reviews

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Frequently asked questions

How do I look up SUMMER CLARK (M.D.) by NPI?
Use NPI 1154736643 when you need to reference SUMMER CLARK (M.D.) in forms, claims, or directories.
Does this profile mean SUMMER CLARK (M.D.) is currently active?
Yes — SUMMER CLARK (M.D.) appears active in the national provider directory.
Does SUMMER CLARK (M.D.) list a primary specialty?
If you are matching referrals, note MOHS-Micrographic Surgery Physician for SUMMER CLARK (M.D.). Clinical services aligned with this taxonomy classification.
Where does public data place SUMMER CLARK (M.D.)?
The snapshot lists Amarillo, Texas for SUMMER CLARK (M.D.); download NPPES for the complete set.
What if Amarillo, Texas seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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