ORA ORTHOPEDICS PC – Orthopaedic Surgery Physician, NPI 1962481861

ORA ORTHOPEDICS PC is a healthcare provider. based in Moline, Illinois. specializing in Orthopaedic Surgery Physician. The organization holds a License No. 060006850 (IL). The NPI Number for ORA ORTHOPEDICS PC is 1962481861

Main info

Organization
Name
ORA ORTHOPEDICS PC
NPI
1962481861
Phone
(309) 762-3621
Address
520 VALLEY VIEW DR
Authorized Official
KENNETH BROCKMAN CEO
Enumeration Date
10 January 2006
Last Update Date
3 March 2026
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience74
Completeness85
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for ORA ORTHOPEDICS PC

  • 520, Valley View Drive, Moline, Rock Island County, Illinois, 61265, United States

    MOLINE, IL 612656194

    Phone: (309) 762-3621

    Fax: (309) 762-3690

    Mailing address matches the actual address.

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: 2010-09-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-08-31 (281 days ago).

Enrollment records

3

Earliest due date

2025-08-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20040216001316OClinic/Group PracticeIA2025-09-30
O20040407001036OClinic/Group PracticeIL2025-10-31
O20100930068751OPhysician - Orthopedic/Orthopedic SurgeryIL2025-08-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

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 61265)

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Reviews

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Frequently asked questions

Is ORA ORTHOPEDICS PC listed with a National Provider Identifier?
Yes — ORA ORTHOPEDICS PC has NPI 1962481861 on file in the registry.
Is ORA ORTHOPEDICS PC shown as active in public data?
Registry records indicate ORA ORTHOPEDICS PC maintains an active NPI.
What expertise is attributed to ORA ORTHOPEDICS PC?
ORA ORTHOPEDICS PC's specialty line reads Orthopaedic Surgery Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with ORA ORTHOPEDICS PC?
Directory geography for ORA ORTHOPEDICS PC centers on Moline, Illinois.
When was this NPI issued?
Enumeration for ORA ORTHOPEDICS PC is noted as January 10, 2006 where the registry provides it.

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ORA ORTHOPEDICS PC

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ORA ORTHOPEDICS PC

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520, Valley View Drive, Moline, Rock Island County, Illinois, 61265, United States
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DR. JASON CRAIG CLARK (M.D.)

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