DR. SUSAN CHRISTINE CLARK (MD) – Surgery Physician, NPI 1104096650
Surgery Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
1,254 GENERAL SURGERY in NC
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Provider Addresses for DR. SUSAN CHRISTINE CLARK (MD)
NAVAL MEDICAL CENTER PORTSMOUTH
620 JOHN PAUL JONES CIRCLE
PORTSMOUTH, VA 237089971
Phone: (757) 953-9759
Type: Mailing
Box Street, Port Charlotte, Charlotte County, Florida, 33948, United States
ECU PHYSICIANS
CHARLOTTE, NC 282751069
Phone:
Type: Mailing
Moye Boulevard, Village Grove, Greenville, Pitt County, North Carolina, 27834, United States
ECU PHYSICIANS SURGERY - MOYE MEDICAL CENTER #2
GREENVILLE, NC 278342849
Phone: (252) 744-2393
Fax: (252) 744-0018
Type: Location
NMRTC PORTSMOUTH
620 JOHN PAUL JONES CIRCLE
PORTSMOUTH, VA 23708
Phone: (757) 953-2549
Fax: (757) 953-0845
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $10,000.
Total Amount is formed as General ($10,000) + Research ($0) + Ownership ($0) = $10,000.
Last reported payment date: 2023-11-17 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($10,000).
Total Amount
$10,000
General + Research + Ownership
Payments
4
Total payment records
General Amount
$10,000
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-11-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Intuitive Surgical, Inc. | $10,000 |
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: 2025-08-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20131008001525 | I | General Surgery | VA | TBD |
| I20250813000958 | I | General Surgery | ME | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 23708)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | ME | |
| Physician Assistant | ME | |
| Nurse Practitioner | ME | |
| - | ME | |
| Physician Assistant | ME | |
| Certified Registered Nurse Anesthetist (Crna) | ME | |
| Family Practice | ME | |
| Family Practice | ME | |
| Nurse Practitioner | ME | |
| P O D I A T R Y | ME |
Reviews
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