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DR. SHANE ALEXANDER CLARK O.D.
NPI 1437446440
Optometrist in Rapid City, SD

Active since June 29, 2011PECOS EnrolledAccepts Medicare Assignment
5734 SHERIDAN LAKE RD, SUITE 202, RAPID CITY, SD 57702(605) 342-0258(605) 342-0209 Get Directions Write a Review

NPPES record last updated: August 10, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 10, 2023, Mar 3, 2016, Jan 11, 2016 (3 updates tracked since 2016).

About Dr. Shane Alexander Clark O.d. NPPES

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

DR. SHANE ALEXANDER CLARK O.D. (NPI 1437446440) is an individual optometrist in Rapid City, South Dakota, licensed in South Dakota (725) and active in the NPI registry since June 2011. He is enrolled in Medicare PECOS and is a graduate of Southern College Of Optometry (2011).

NPPES Registry Identity

NPI1437446440
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. SHANE ALEXANDER CLARKCredential: O.D.
Location Address5734 SHERIDAN LAKE RD, SUITE 202Rapid City, SD 57702-8811
Mailing Address3027 Roxbury CirRapid City, SD 57702-5301 · (816) 853-9407 · Fax (605) 342-0209
Phone(605) 342-0258
Fax(605) 342-0209
Sole ProprietorNo
Medical School CMSSouthern College Of OptometryGraduated 2011
Enumeration DateJune 29, 2011
Last NPPES UpdateAugust 10, 20233 updates tracked since enumeration
NPPES CertifiedAugust 10, 2023
✔ NPI 1437446440 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 SD · 725
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.
5734 SHERIDAN LAKE RD, Rapid City, SD 57702
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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 and accepts Medicare assignment

Dr. Shane Alexander Clark O.d. 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 ID2264600394
PECOS Enrollment IDI20160711002093
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

3

Medicare enrollment records show Shane Clark reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Infinity Eyecare, PC
Same address
Optometrist
5734 SHERIDAN LAKE RD, SUITE 202
Rapid City, SD 57702
  • Reassigned Medicare billing, South Dakota enrollment
NPI 1306202700 (605) 342-0258
Black Hills Regional Eye Institute, LLP
3.2 mi
Ophthalmology
2800 3RD ST
Rapid City, SD 57701
  • Reassigned Medicare billing, South Dakota enrollment
  • 21 clinicians in this Medicare group
NPI 1952381881 (605) 341-2000
Dr. Mark Lynn & Associates, PLLC
1,033 mi
Optometrist
1800 GALLERIA BLVD, 1330
Franklin, TN 37067
  • Reassigned Medicare billing, Tennessee enrollment
  • Medicare enrollment name: Ky Doctors Of Optometry, PLLC
  • 58 clinicians in this Medicare group
NPI 1194739490 (615) 771-7382

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 4

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 complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
31 services30 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
17 services11 patients
Established patient problem focused exam of visual system 92012
This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
14 services14 patients
New patient complete exam of visual system 92004
A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 57702 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
$126.78 typical visit price
range $55.52 – $167.23
Typical copayment $31.69 (range $13.88 – $41.80)
Most-billed visit code 99204
Established Patient
$69.20 typical visit price
range $18.08 – $137.08
Typical copayment $17.30 (range $4.52 – $34.27)
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

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

INFINITY EYECARE, PC
Optometrist
5734 SHERIDAN LAKE RD, SUITE 202
RAPID CITY, SD 57702
Pennington County (605) 342-0258

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 Shane Clark's NPI number?

The NPI number for Shane Clark is 1437446440. It was assigned to this individual provider in the NPPES registry on June 29, 2011.

Where is Shane Clark located?

Shane Clark practices at 5734 Sheridan Lake Rd Suite 202, Rapid City, SD 57702. The listed phone number is (605) 342-0258.

What is Shane Clark's specialty?

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

Is Shane Clark enrolled in Medicare?

Yes. Shane Clark 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 Shane Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shane Clark reassigns Medicare benefits to 3 organizations: Infinity Eyecare, PC (Rapid City, SD), Black Hills Regional Eye Institute, LLP (Rapid City, SD) and Dr. Mark Lynn & Associates, PLLC (Franklin, TN). 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 Shane Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Shane 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 BlueCross BlueShield of Tennessee and 3 other insurers list Shane 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 Shane Clark was last updated on August 10, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.