MRS. SUSAN D. CLARK (NP-C) – Family Nurse Practitioner, NPI 1770964991

MRS. SUSAN D. CLARK (NP-C) is a healthcare provider. based in Liberty, Texas. specializing in Family Nurse Practitioner. They hold the professional credentials NP-C. They hold a License No. AP128323 (TX). The NPI Number for MRS. SUSAN D. CLARK (NP-C) is 1770964991

Main info

Female
11 Years Of Experience
Accepts Medicare Assignment
Name
MRS. SUSAN D. CLARK (NP-C)
NPI
1770964991
Phone
(936) 336-5881
Address
1353 N TRAVIS ST
Enumeration Date
12 June 2015
Last Update Date
12 June 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4098531526
Graduation Year
2015 (11 years ago)
PAC ID
2668752304
Group Practice PAC ID
5597084392
Professional Enrollment ID
I20161215000101
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

Provider Addresses for MRS. SUSAN D. CLARK (NP-C)

  • 1353 N TRAVIS ST

    LIBERTY, TX 775753549

    Phone: (936) 336-5881

    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: 2016-12-15

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
I20161215000101INurse PractitionerTXTBD

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 minutes129107$0
99203New patient office or other outpatient visit, 30-44 minutes4949$0
87637Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (covid-19), influenza virus types a and b, and respiratory syncytial virus4242$0
0241URespiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid 19), influenza a, influenza b, and respiratory syncytial virus, upper respiratory specimen, each reported as detected or not detected3231$0
81003Automated urinalysis test3125$0
View full utilization report →

Insurance plans in this area (ZIP 77575)

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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: 5597084392View full group profile

Reviews

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Frequently asked questions

What identifier follows MRS. SUSAN D. CLARK (NP-C) across health systems?
The NPI 1770964991 uniquely identifies MRS. SUSAN D. CLARK (NP-C) in U.S. healthcare data.
Quick check: is MRS. SUSAN D. CLARK (NP-C) active?
Public NPPES data shows MRS. SUSAN D. CLARK (NP-C) with an active NPI status right now.
What services align with MRS. SUSAN D. CLARK (NP-C)'s listing?
MRS. SUSAN D. CLARK (NP-C)'s public classification highlights Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What city is tied to MRS. SUSAN D. CLARK (NP-C)?
The directory associates MRS. SUSAN D. CLARK (NP-C) with Liberty, Texas. Check all listed addresses for suites or satellite offices.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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