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Deactivated NPI 1447240585 Deactivated / Inactive NPI Male Practitioner

Dr. Michael Clark , OD

Optometrist • Chandler, AZ

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Michael Clark has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 27, 2005
NPI Deactivation Date August 23, 2023
Total Practice Duration ~18 Years of Practice (2005 – 2023)

Professional Overview & Biography Verified Profile Summary

Dr. Michael Clark, OD was a registered Optometrist practicing in Chandler, AZ. Throughout an active medical career spanning 18 years, Dr. Clark provided care at the practice location at 220 N MCKEMY AVE until profile deactivation on 2023-08-23.

Historical Medicare Part B clinical services included new patient outpatient office visit, established patient outpatient office visit. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

220 N Mckemy Ave

Chandler, AZ 852262654

Telephone 4809611865
Fax 4809614605
Associated Practice Facility / Clinic
🏢 Nationwide Optometry P.c. Facility NPI 1881764157

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Chandler, AZ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 19.6 Yrs
State Avg: 20.2 Yrs
Regional Practice Density
98 Specialists

Practicing in Chandler, AZ (1373 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
28.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2019)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more
20 20 $150.29 $106.42
99213 Established patient office or other outpatient visit, typically 15 minutes
11 11 $101.57 $73.27

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License AZ 0475

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

30 Associated Practitioners
NPI 1083602213

Doctor of Optometry

NPI 1093703670

Doctor of Optometry

NPI 1114015443

Doctor of Optometry

NPI 1124227160

Doctor of Optometry

NPI 1124228259

Doctor of Optometry

NPI 1144565003

Doctor of Optometry

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated August 23, 2023

Record deactivated on August 23, 2023

NPI Profile Active May 06, 2014

NPI status registered as active in NPPES database

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Updated Practice Location May 06, 2014

Registered at 220 N MCKEMY AVE, CHANDLER, AZ 852262654 (Tel: 4809611865)

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Updated Business Mailing Address May 06, 2014

Registered at 220 N MCKEMY AVE, CHANDLER, AZ 852262654 (Tel: 4809611865)

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Provider Name / Credentials Updated May 06, 2014

Recorded as MICHAEL CLARK, O.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 06, 2014

Optometrist (License #0475 in AZ)

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Initial NPI Registration & Enumeration October 27, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1447240585
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 27, 2005
Last Update: May 06, 2014
Deactivation Date: August 23, 2023

Mailing Address

220 N Mckemy Ave

Chandler, AZ 852262654

Phone: 4809611865

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.