JENNIE T CLARKE (MD) – Dermatology Physician, NPI 1447214655
Dermatology Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
197 DERMATOLOGY in UT
Loading map...
Provider Addresses for JENNIE T CLARKE (MD)
50, North Medical Drive, Salt Lake City, Salt Lake County, Utah, 84113, United States
SALT LAKE CITY, UT 841320001
Phone: (801) 581-2955
Fax: (801) 581-2307
Type: Location
Salt Lake City Post Office, 1760, 2100 South, Salt Lake City, Salt Lake County, Utah, 84199, United States
SALT LAKE CITY, UT 841103208
Phone: (801) 587-6340
Fax: (801) 587-6346
Type: Mailing
PO BOX 841052
LOS ANGELES, CA 900841052
Phone: (801) 587-6340
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $18.
Total Amount is formed as General ($18) + Research ($0) + Ownership ($0) = $18.
Last reported payment date: 2023-05-17 • Largest payer in this snapshot: Lilly USA, LLC ($18).
Total Amount
$18
General + Research + Ownership
Payments
1
Total payment records
General Amount
$18
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-05-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $18 |
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: 2015-01-27
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 |
|---|---|---|---|---|
| I20150127000106 | I | Dermatology | 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 |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 1,119 | 223 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 670 | 542 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 387 | 312 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 287 | 221 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 235 | 211 | $0 |
Insurance plans in this area (ZIP 84132)
Loading plans...
Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DERMATOLOGY | UT | 17003 | Destruction of 2-14 skin growths | 37 | 13 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | UT | |
| D E R M A T O L O G Y | UT | |
| D E R M A T O L O G Y | TN | |
| D E R M A T O L O G Y | CA | |
| P A T H O L O G Y | UT | |
| D E R M A T O L O G Y | UT | |
| D E R M A T O L O G Y | UT | |
| D E R M A T O L O G Y | UT | |
| D E R M A T O L O G Y | PA | |
| - | UT |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.