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Deactivated NPI 1205820081 Deactivated / Inactive NPI Male Practitioner

Dr. Daryle L Clark , OD

Optometrist • Gillette, WY

✓ Accepts Medicare Assignment
⚠️

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. Daryle Clark has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 07, 2005
NPI Deactivation Date March 25, 2006
Total Practice Duration ~16 Years of Practice (1990 – 2006)

Professional Overview & Biography Verified Profile Summary

Dr. Daryle Clark, OD was a registered Optometrist in Gillette, WY. Prior to record deactivation on 2006-03-25, Dr. Clark completed approximately 16 years of clinical practice following graduation from Pacific University - College Of Optometry in 1990.

Dr. Clark was affiliated with Eye Care Associates Of Wyoming, P.C. and accepted Medicare assignment.

Historical Medicare Part B clinical services included established patient complete exam of visual system, imaging of retina, 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

312 E Lakeway Rd

Gillette, WY 827186329

Telephone 3076877353
Fax 3076861052
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Pacific University - College Of Optometry

Graduation Year

1990

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Gillette, WY

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
36 Yrs +15.0 yrs vs City Avg
City Avg: 21.0 Yrs
State Avg: 20.1 Yrs
Regional Practice Density
10 Specialists

Practicing in Gillette, WY (156 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
52.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Clark (36 Years) 36 Yrs
Gillette Specialty Average (21.0 Years) 21.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
92014 Established patient complete exam of visual system
234 227 $153.73 $123.15
92134 Imaging of retina
95 89 $84.00 $39.23
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more
51 44 $144.12 $54.89
92250 Photography of the retina
49 48 $109.00 $36.20
66984 Removal of cataract with insertion of lens
49 29 $400.00 $103.88
99213 Established patient office or other outpatient visit, typically 15 minutes
43 39 $168.00 $88.45
92004 New patient complete exam of visual system
34 34 $160.16 $145.17
92133 Imaging of optic nerve
15 15 $82.80 $34.73
92082 Exam of visual field with intermediate testing
15 15 $109.00 $46.11

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License WY 191T

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
104289100 (WY)

Hospital & Practice Group Affiliations

Eye Care Associates Of Wyoming, P.c.

312 E Lakeway Rd, Gillette, WY 827186329

Phone: 3076862010

Practice Associates & Co-Workers

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

1 Associated Practitioners
NPI 1215929021

Doctor of Optometry

Career & Practice History Timeline

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

7 Historical Events
📍
Updated Practice Location December 05, 2015

Registered at 312 E LAKEWAY RD, GILLETTE, WY 827186329 (Tel: 3076877353)

📍
Updated Business Mailing Address December 05, 2015

Registered at 312 E LAKEWAY RD, GILLETTE, WY 827186329 (Tel: 3076862010)

👤
Provider Name / Credentials Updated December 05, 2015

Recorded as DARYLE CLARK, OD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 05, 2015

Optometrist (License #191T in WY)

🔄
NPI Profile Reactivated April 12, 2006

Record officially reactivated for active practice on April 12, 2006

⚠️
NPI Profile Deactivated March 25, 2006

Record deactivated on March 25, 2006

🟢
Initial NPI Registration & Enumeration September 07, 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: 1205820081
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 07, 2005
Last Update: December 05, 2015
Deactivation Date: March 25, 2006
Sole Proprietor: No

Mailing Address

312 E Lakeway Rd

Gillette, WY 827186329

Phone: 3076862010

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.