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DR. SAMUEL DAMAIN PEPETO CLARKE MD
NPI 1013529304
Family Medicine in Ormond Beach, FL

Active since August 19, 2020PECOS EnrolledAccepts Medicare Assignment
300 CLYDE MORRIS BLVD STE A, ORMOND BEACH, FL 32174(386) 317-8620(386) 317-8625 Get Directions Write a Review

NPPES record last updated: January 6, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 6, 2025, Aug 19, 2020 (2 updates tracked since 2020).

About Dr. Samuel Damain Pepeto Clarke Md NPPES

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

DR. SAMUEL DAMAIN PEPETO CLARKE MD (NPI 1013529304) is an individual family medicine provider in Ormond Beach, Florida, licensed in Florida (ME162657) and active in the NPI registry since August 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1013529304
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. SAMUEL DAMAIN PEPETO CLARKECredential: MD
Location Address300 CLYDE MORRIS BLVD STE AOrmond Beach, FL 32174-5909
Mailing Address300 Clyde Morris Blvd Ste AOrmond Beach, FL 32174-5909 · (386) 317-8620 · Fax (386) 317-8625
Phone(386) 317-8620
Fax(386) 317-8625
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateAugust 19, 2020
Last NPPES UpdateJanuary 6, 20252 updates tracked since enumeration
NPPES CertifiedDecember 31, 2024
✔ NPI 1013529304 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in FL · ME162657
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
300 CLYDE MORRIS BLVD STE A, Ormond Beach, FL 32174
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Florida Health Care Plans.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Samuel Damain Pepeto Clarke Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9436596806
PECOS Enrollment IDI20240320003187
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 Reassignments

2

Medicare enrollment records show Samuel Clarke reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Florida Health Care Plan, Inc
4.1 mi
Preferred Provider Organization
2450 MASON AVE
Daytona Beach, FL 32114
  • Reassigned Medicare billing, Florida enrollment
  • 132 clinicians in this Medicare group
NPI 1558302042 (386) 615-4021
Agapemd, LLC
296 mi
Health Service
90130 OLD HWY
Tavernier, FL 33070
  • Reassigned Medicare billing, Florida enrollment
  • 10 clinicians in this Medicare group
NPI 1639561186 (305) 852-9300

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

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
25 services25 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
24 services24 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32174 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
Most-billed visit code 99214
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 4

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

DR. JAMES WELLS BUTLER DO
Family Medicine
300 CLYDE MORRIS BLVD STE A
ORMOND BEACH, FL 32174
Flagler County (386) 317-8620
GERALD MICELI M.D.
Internal Medicine (Endocrinology, Diabetes & Metabolism)
300 CLYDE MORRIS BLVD STE A
ORMOND BEACH, FL 32174
Flagler County (386) 317-8620
ROBERTA ASHLEY EKHOLM DO
Family Medicine
300 CLYDE MORRIS BLVD STE A
ORMOND BEACH, FL 32174
Flagler County (386) 317-8620
DHARA PATEL MD
Internal Medicine (Endocrinology, Diabetes & Metabolism)
300 CLYDE MORRIS BLVD STE A
ORMOND BEACH, FL 32174
Flagler County (386) 317-8620

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 Samuel Clarke's NPI number?

The NPI number for Samuel Clarke is 1013529304. It was assigned to this individual provider in the NPPES registry on August 19, 2020.

Where is Samuel Clarke located?

Samuel Clarke practices at 300 Clyde Morris Blvd Ste A, Ormond Beach, FL 32174. The listed phone number is (386) 317-8620.

What is Samuel Clarke's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Samuel Clarke enrolled in Medicare?

Yes. Samuel Clarke is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Samuel Clarke's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Clarke reassigns Medicare benefits to 2 organizations: Florida Health Care Plan, Inc (Daytona Beach, FL) and Agapemd, LLC (Tavernier, FL). Each 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 Samuel Clarke's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Samuel Clarke accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Florida Health Care Plans list Samuel Clarke 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 Samuel Clarke was last updated on January 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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.