CLARK GRAVELL (MD) – Dermatology Physician, NPI 1518545961

CLARK GRAVELL (MD) is a healthcare provider. based in San antonio, Texas. specializing in DERMATOLOGY. They hold the professional credentials MD. They hold a License No. V5269 (TX). The NPI Number for CLARK GRAVELL (MD) is 1518545961

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
CLARK GRAVELL (MD)
NPI
1518545961
Phone
(210) 358-3555
Address
4502 Medical Dr
Enumeration Date
29 March 2021
Last Update Date
15 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5124447208
Graduation Year
2021 (5 years ago)
PAC ID
4880101567
Group Practice PAC ID
9133429715
Professional Enrollment ID
I20250728002755
Address ID
TX787358978AU5625XRDXX302
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness85
Years active:5State licenses:1Digital endpointsOther names

1,287 DERMATOLOGY in TX

Provider Addresses for CLARK GRAVELL (MD)

  • 4502 Medical Dr

    San Antonio, TX 782294402

    Phone: (210) 358-3555

    Fax: (210) 702-4239

    Type: Location

  • 4419 FRONTIER TRL STE 110

    AUSTIN, TX 787451567

    Phone: (512) 968-3125

    Type: Mailing

  • 7703 FLOYD CURL DR

    SAN ANTONIO, TX 782293901

    Phone:

    Type: Mailing

  • 4502 MEDICAL DR

    SAN ANTONIO, TX 782294402

    Phone: (210) 358-3555

    Fax: (210) 702-4239

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $122.

Total Amount is formed as General ($122) + Research ($0) + Ownership ($0) = $122.

Last reported payment date: 2024-11-19 • Largest payer in this snapshot: SUN PHARMACEUTICAL INDUSTRIES INC. ($122).

Total Amount

$122

General + Research + Ownership

Payments

1

Total payment records

General Amount

$122

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-19

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: 2025-07-28

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
I20250728002755IDermatologyTXTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 78229)

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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: 9133429715View full group profile
NameSpecialtyState
D E R M A T O L O G YCA
D E R M A T O L O G YTX
D E R M A T O L O G YTX
Micrographic Dermatologic Surgery (Mds), DermatologyTX
D E R M A T O L O G YTX
D E R M A T O L O G YMN
D E R M A T O L O G YTX

Reviews

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Frequently asked questions

How do payers reference CLARK GRAVELL (MD)?
For CLARK GRAVELL (MD), use NPI 1518545961 as the unique 10-digit identifier.
Is CLARK GRAVELL (MD) still an active registrant?
CLARK GRAVELL (MD) carries an active NPI according to the public dataset.
What kind of doctor is CLARK GRAVELL (MD)?
CLARK GRAVELL (MD) is associated with Dermatology Physician in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for CLARK GRAVELL (MD)?
Travel planning: use San Antonio, Texas as the reference point for CLARK GRAVELL (MD), then confirm.
Can I trust this NPI listing for CLARK GRAVELL (MD)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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