RYAN WILLIAM CLARK (D.O.) – Interventional Pain Medicine Physician, NPI 1720499759
Interventional Pain Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
64 INTERVENTIONAL PAIN MANAGEMENT in WI
Provider Addresses for RYAN WILLIAM CLARK (D.O.)
12203 CORPORATE PKWY
MEQUON, WI 530923388
Phone: (262) 387-8200
Fax: (262) 387-8239
Type: Mailing
1035 KEPLER DR
GREEN BAY, WI 543118320
Phone: (920) 288-8377
Fax: (920) 405-8005
Type: Mailing
2845 GREENBRIER RD
GREEN BAY, WI 543116519
Phone: (920) 288-8377
Fax: (920) 288-8385
Type: Location
PO BOX 28900
GREEN BAY, WI 543240900
Phone: (920) 288-8377
Fax: (920) 288-8385
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 63 Open Payments records for all available years, with a total value of $3,213.
Total Amount is formed as General ($3,213) + Research ($0) + Ownership ($0) = $3,213.
Last reported payment date: 2024-12-09 • Largest payer in this snapshot: Abbott Laboratories ($941).
Total Amount
$3,213
General + Research + Ownership
Payments
63
Total payment records
General Amount
$3,213
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-09
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Abbott Laboratories | $941 |
| SPR Therapeutics, Inc | $747 |
| Medtronic, Inc. | $373 |
| Boston Scientific Corporation | $307 |
| Nevro Corp. | $213 |
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: 2018-09-11
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 |
|---|---|---|---|---|
| I20180911000823 | I | Interventional Pain Management | WI | 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 |
|---|---|---|---|---|
| J0585 | Injection, onabotulinumtoxina, 1 unit | 14,655 | 18 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 388 | 235 | $0 |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 272 | 47 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 189 | 189 | $0 |
| 62323 | Injection of substance into lower spine canal using imaging guidance | 143 | 109 | $0 |
Insurance plans in this area (ZIP 53092)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P H T H A L M O L O G Y | WI | |
| O P T O M E T R Y | WI | |
| N E U R O S U R G E R Y | WI | |
| O P T O M E T R Y | WI | |
| Certified Registered Nurse Anesthetist (Crna) | WI | |
| Emergency Medicine | WI | |
| Plastic And Reconstructive Surgery | WI | |
| Physician Assistant | WI | |
| O P H T H A L M O L O G Y | WI | |
| Diagnostic Radiology | WI |
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