Thomas Edward Clark, OD - Medicare Optometrist in South Jordan, UT

Thomas Edward Clark, OD is a medicare enrolled "Optometrist" provider in South Jordan, Utah. He graduated from medical school in 2020 and has 4 years of diverse experience with area of expertise as Optometry. He is a member of the group practice Utah Vision Development Center, Llc and his current practice location is 3672 W South Jordan Pkwy Ste 103, South Jordan, Utah. You can reach out to his office (for appointments etc.) via phone at (801) 810-1060.

Thomas Edward Clark is licensed to practice in Utah (license number 11777686-9934) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1669096020.

Contact Information

Thomas Edward Clark, OD
3672 W South Jordan Pkwy Ste 103,
South Jordan, UT 84009-7172
(801) 810-1060
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameThomas Edward Clark
GenderMale
SpecialityOptometry
Experience4 Years
Location3672 W South Jordan Pkwy Ste 103, South Jordan, Utah
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Thomas Edward Clark graduated from medical school in 2020
  NPI Data:
  • NPI Number: 1669096020
  • Provider Enumeration Date: 06/02/2020
  • Last Update Date: 06/02/2020
  Medicare PECOS Information:
  • PECOS PAC ID: 4385060037
  • Enrollment ID: I20200812002801

Medical Identifiers

Medical identifiers for Thomas Edward Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1669096020NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
152WP0200XOptometrist - Pediatrics 11777686-9934 (Utah)Secondary
152WS0006XOptometrist - Sports Vision 11777686-9934 (Utah)Secondary
152WV0400XOptometrist - Vision Therapy 11777686-9934 (Utah)Secondary
152W00000XOptometrist 11777686-9934 (Utah)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Utah Vision Development Center, Llc85272413632

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Thomas Edward Clark allows following entities to bill medicare on his behalf.
Provider NameKenneth E Hooton, O.d.
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1134390255
PECOS PAC ID: 1658341953
Enrollment ID: O20040726001144
Provider NameUtah Vision Development Center, Llc
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1104123801
PECOS PAC ID: 8527241363
Enrollment ID: O20110331000619

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Thomas Edward Clark is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Thomas Edward Clark, OD
458 E 200 N,
Pleasant Grove, UT 84062-2821

Ph: (385) 439-7172
Thomas Edward Clark, OD
3672 W South Jordan Pkwy Ste 103,
South Jordan, UT 84009-7172

Ph: (801) 810-1060

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.