DR. MICHELLE OLIVETTE CLARK (M.D.) – Psychiatry Physician, NPI 1164551545
Psychiatry Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. MICHELLE OLIVETTE CLARK (M.D.)
10921 WILSHIRE BLVD
SUITE 405
LOS ANGELES, CA 900243906
Phone: (323) 298-1114
Fax: (323) 298-1113
Type: Mailing
4100 Redwood Rd Ste 20A-522
Oakland, CA 946192363
Phone: (510) 842-8960
Fax: (510) 843-8983
Type: Location
4100 REDWOOD RD STE 20A-522
OAKLAND, CA 946192363
Phone: (510) 842-8960
Fax: (105) 842-8983
Type: Mailing
1005 ATLANTIC AVE
ALAMEDA, CA 945011148
Phone: (415) 474-7310
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $180.
Total Amount is formed as General ($180) + Research ($0) + Ownership ($0) = $180.
Last reported payment date: 2024-08-05 • Largest payer in this snapshot: Otsuka America Pharmaceutical, Inc. ($96).
Total Amount
$180
General + Research + Ownership
Payments
2
Total payment records
General Amount
$180
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Otsuka America Pharmaceutical, Inc. | $96 |
| ACADIA Pharmaceuticals Inc | $84 |
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: 2006-01-19
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 |
|---|---|---|---|---|
| I20060119000747 | I | Psychiatry | CA | 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 90024)
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