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DR. CAROLYN SUE CLARK O.D.
NPI 1013079771
Optometrist - Vision Therapy in Dublin, OH

Active since December 15, 2006PECOS Enrolled
4925 BRADENTON AVE, SUITE A, DUBLIN, OH 43017(614) 792-1974(614) 760-1996 Get Directions Write a Review

NPPES record last updated: May 18, 2018. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Carolyn Sue Clark O.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. CAROLYN SUE CLARK O.D. (NPI 1013079771) is an individual vision therapy provider in Dublin, Ohio, licensed in Ohio (4089) and active in the NPI registry since December 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1013079771
Entity TypeIndividualFemale
Primary Taxonomy152WV0400X
Provider Legal NameDR. CAROLYN SUE CLARKCredential: O.D.
Location Address4925 BRADENTON AVE, SUITE ADublin, OH 43017-7532
Mailing Address4925 Bradenton Ave, Suite ADublin, OH 43017-7532 · (614) 792-1974 · Fax (614) 760-1996
Phone(614) 792-1974
Fax(614) 760-1996
Sole ProprietorYes
Enumeration DateDecember 15, 2006
Last NPPES UpdateMay 18, 2018
✔ NPI 1013079771 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometrist · Vision TherapyEye and Vision Services Providers
Taxonomy Code152WV0400X
License✔ Licensed in OH · 4089
Definition
Optometrists who specialize in vision therapy as a treatment process used to improve vision function. It includes a broad range of developmental and rehabilitative treatment programs individually prescribed to remediate specific sensory, motor and/or visual perceptual dysfunctions.
4925 BRADENTON AVE, Dublin, OH 43017
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Other Identifiers 1

Medicaid0762509OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Carolyn Sue Clark O.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Carolyn Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Dublin Family Vision Center Inc
Same address
Optometrist
4925 BRADENTON AVE, SUITE A
Dublin, OH 43017
  • Reassigned Medicare billing, Ohio enrollment
  • 2 clinicians in this Medicare group
NPI 1982986204 (614) 792-1974

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43017 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.12 typical visit price
range $54.34 – $166.65
Typical copayment $31.53 (range $13.58 – $41.66)
Most-billed visit code 99204
Established Patient
$68.07 typical visit price
range $17.10 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. THOMAS M SHIRCK D.O.
Otolaryngology (Plastic Surgery within the Head & Neck)
4925 BRADENTON AVE, SUITE C
DUBLIN, OH 43017
Franklin County (614) 336-7666
DUBLIN FAMILY VISION CENTER INC
Optometrist
4925 BRADENTON AVE, SUITE A
DUBLIN, OH 43017
Franklin County (614) 792-1974

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carolyn Clark's NPI number?

The NPI number for Carolyn Clark is 1013079771. It was assigned to this individual provider in the NPPES registry on December 15, 2006.

Where is Carolyn Clark located?

Carolyn Clark practices at 4925 Bradenton Ave Suite A, Dublin, OH 43017. The listed phone number is (614) 792-1974.

What is Carolyn Clark's specialty?

The primary specialty registered for this NPI is Optometrist, specializing in Vision Therapy, with taxonomy code 152WV0400X.

Is Carolyn Clark enrolled in Medicare?

Yes. Carolyn Clark is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Carolyn Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carolyn Clark reassigns Medicare benefits to Dublin Family Vision Center Inc (Dublin, OH). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Carolyn Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Carolyn Clark accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and CareSource and 7 other insurers list Carolyn Clark as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Carolyn Clark was last updated on May 18, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.