KATIE CLARK OD
NPI 1164092383
Optometrist in Louisville, KY

Q: What is Katie Clark's NPI number?

The NPI number for Katie Clark is 1164092383. It was assigned to this individual provider in the NPPES registry on June 29, 2021.

Q: What is Katie Clark's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Q: When was this NPI record last updated?

The NPPES record for Katie Clark was last updated on January 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since June 29, 2021PECOS EnrolledAccepts Medicare Assignment

3408 BARDSTOWN RD, LOUISVILLE, KY 40218(502) 912-9884 Get Directions Write a Review

NPPES record last updated: January 29, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 29, 2026, Jun 29, 2021 (2 updates tracked since 2021).

On this page

About Katie Clark Od NPPES

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

KATIE CLARK OD (NPI 1164092383) is an individual optometrist in Louisville, Kentucky, licensed in Minnesota (3740) and active in the NPI registry since June 2021. She is enrolled in Medicare PECOS and is a graduate of Indiana University - School Of Optometry (2021).

NPPES Registry Identity

NPI1164092383

Entity TypeIndividualFemale

Primary Taxonomy152W00000X

Provider Legal NameKATIE CLARKCredential: OD

Location Address3408 BARDSTOWN RDLouisville, KY 40218-4608

Mailing Address8639 County Road 16 SeDelano, MN 55328-8134 · (612) 709-8661

Phone(502) 912-9884

Sole ProprietorNo

Medical School CMSIndiana University - School Of OptometryGraduated 2021

Enumeration DateJune 29, 2021

Last NPPES UpdateJanuary 29, 20262 updates tracked since enumeration

NPPES CertifiedJanuary 29, 2026

✔ NPI 1164092383 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

License✔ Licensed in MN · 3740

Definition

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.

3408 BARDSTOWN RD, Louisville, KY 40218

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Katie Clark Od 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 ID8123422300

PECOS Enrollment IDI20250108003597

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40218 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

$122.77 typical visit price

range $52.76 – $162.27

Typical copayment $30.69 (range $13.19 – $40.56)

Most-billed visit code 99204

Established Patient

$66.24 typical visit price

range $16.53 – $131.99

Typical copayment $16.56 (range $4.13 – $32.99)

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 13

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

DR. JESSICA MATTICHE PHARMD

Pharmacist