BRADLEY J CLARK (DO) – Pediatrics Physician, NPI 1649532466
Pediatrics Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for BRADLEY J CLARK (DO)
3485 W 5200 S
ROY, UT 840679438
Phone: (801) 475-3900
Fax: (801) 475-3901
Type: Location
145 S 3000 W
WEST POINT, UT 84015
Phone: (801) 475-3960
Fax: (801) 475-3961
Type: Location
PO BOX 5546
DENVER, CO 802175546
Phone: (801) 475-3500
Fax: (801) 475-3494
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 19 Open Payments records for all available years, with a total value of $324.
Total Amount is formed as General ($324) + Research ($0) + Ownership ($0) = $324.
Last reported payment date: 2024-11-12 • Largest payer in this snapshot: Inspire Medical Systems, Inc. ($44).
Total Amount
$324
General + Research + Ownership
Payments
19
Total payment records
General Amount
$324
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-12
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2015-08-21
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 |
|---|---|---|---|---|
| I20150821014319 | I | Pediatric Medicine | UT | 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 84067)
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Reviews
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