THOMAS H CLARK (MD) – Family Medicine Physician, NPI 1295741114
Family Medicine Physician
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Profile Insights
NPPES metrics only — not quality of care.
1,136 FAMILY PRACTICE in UT
Provider Addresses for THOMAS H CLARK (MD)
412, North 200 East, Logan, Cache County, Utah, 84321, United States
LOGAN, UT 843214038
Phone: (435) 713-2800
Type: Mailing
595 W 465 N
PROVIDENCE, UT 84332
Phone: (385) 238-3900
Fax: (385) 238-3901
Type: Location
PO BOX 5546
DENVER, CO 802175546
Phone: (801) 475-3500
Fax: (801) 475-3489
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 294 Open Payments records for all available years, with a total value of $115,764.
Total Amount is formed as General ($115,764) + Research ($0) + Ownership ($0) = $115,764.
Last reported payment date: 2024-12-23 • Largest payer in this snapshot: Lilly USA, LLC ($88,700).
Total Amount
$115,764
General + Research + Ownership
Payments
294
Total payment records
General Amount
$115,764
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $88,700 |
| Boehringer Ingelheim Pharmaceuticals, Inc. | $22,098 |
| Eli Lilly and Company | $2,860 |
| Abbott Laboratories | $1,135 |
| Corcept Therapeutics | $189 |
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: 2006-01-11
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 |
|---|---|---|---|---|
| I20060111001244 | I | Family Practice | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 227 | 114 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 109 | 87 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 96 | 96 | $0 |
| 83036 | Hemoglobin a1c level | 58 | 34 | $0 |
| 90694 | Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage | 42 | 42 | $0 |
Insurance plans in this area (ZIP 84321)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | UT | 83036 | Hemoglobin A1C level | 107 | 53 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | CO | |
| Family Practice | CA | |
| Physician Assistant | UT | |
| Physician Assistant | WA | |
| Family Practice | CO | |
| Physician Assistant | NC | |
| Physical Therapist In Private Practice | CO | |
| Physician Assistant | CO | |
| Family Practice | CO | |
| Family Practice | CO |
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