DR. KEVIN N CLARK (MD) – Surgery Physician, NPI 1235127291
Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
238 GENERAL SURGERY in UT
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Provider Addresses for DR. KEVIN N CLARK (MD)
Medical Drive, Bountiful, Davis County, Utah, 84010, United States
STE 101
BOUNTIFUL, UT 840104945
Phone: (801) 298-9409
Fax: (801) 292-1271
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 6 Open Payments records for all available years, with a total value of $147.
Total Amount is formed as General ($147) + Research ($0) + Ownership ($0) = $147.
Last reported payment date: 2023-11-22 • Largest payer in this snapshot: KCI USA, Inc. ($73).
Total Amount
$147
General + Research + Ownership
Payments
6
Total payment records
General Amount
$147
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-11-22
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2011-12-29
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 |
|---|---|---|---|---|
| I20111229000518 | I | General Surgery | UT | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 12 | 12 | $0 |
| 99283 | Emergency department visit with low level of medical decision making | 12 | 12 | $0 |
Insurance plans in this area (ZIP 84010)
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