JACOB A CLARK (MD) – Ophthalmology Physician, NPI 1164464806
Ophthalmology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
565 OPHTHALMOLOGY in VA
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Provider Addresses for JACOB A CLARK (MD)
411-413, North Washington Street, Alexandria Historic District, Jefferson Houston, Alexandria, Virginia, 22314, United States
ALEXANDRIA, VA 223142311
Phone: (703) 548-5588
Fax: (703) 549-1599
Type: Mailing
2661 RIVA RD STE 1030
ANNAPOLIS, MD 214017131
Phone: (667) 354-5528
Type: Mailing
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.
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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: 2010-06-28
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 |
|---|---|---|---|---|
| I20100628000656 | I | Ophthalmology | DC | 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 |
|---|---|---|---|---|
| 92014 | Established patient complete exam of visual system | 601 | 575 | $0 |
| 92012 | Established patient problem focused exam of visual system | 325 | 194 | $0 |
| 92083 | Exam of visual field with extended testing | 194 | 151 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 81 | 81 | $0 |
| 92020 | Exam of the internal drainage system of eye | 51 | 50 | $0 |
Insurance plans in this area (ZIP 22314)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| OPHTHALMOLOGY | VA | 92012 | Eye and medical examination for diagnosis and treatment, established patient | 469 | 266 |
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