BETH E CLARK (PA) – Medical Physician Assistant, NPI 1194715672
Medical Physician Assistant
Main info
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for BETH E CLARK (PA)
Public Storage, 5788, West 6th Avenue, Villa Park, Lakewood, Denver County, Colorado, 80214, United States
DENVER, CO 802175788
Phone: (303) 202-1280
Fax: (303) 202-1281
Type: Mailing
West 2nd Place, Lakewood, Jefferson County, Colorado, 80228, United States
LAKEWOOD, CO 802281527
Phone: (720) 321-4161
Fax: (720) 321-4165
Type: Location
11600 W 2nd Pl
Lakewood, CO 802281527
Phone: (720) 321-4161
Fax: (720) 321-4165
Type: Location
2500 S HAVANA ST
AURORA, CO 800141618
Phone: (303) 338-4545
Type: Location
10350 E DAKOTA AVE
DENVER, CO 802471314
Phone:
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.
This can happen when there are no reportable CMS Open Payments records.
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: 2006-07-12
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 |
|---|---|---|---|---|
| I20060712000071 | I | Physician Assistant | CO | 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 80217)
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