LERONE EVANTON CLARK DO
NPI 1457102741
Radiology - Diagnostic Radiology in Jacksonville, FL

Q: What is Lerone Clark's NPI number?

The NPI number for Lerone Clark is 1457102741. It was assigned to this individual provider in the NPPES registry on March 27, 2024.

Q: What is Lerone Clark's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Q: When was this NPI record last updated?

The NPPES record for Lerone Clark was last updated on May 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 March 27, 2024PECOS Enrolled

4500 SAN PABLO RD S, JACKSONVILLE, FL 32224(904) 953-2000 Get Directions Write a Review

NPPES record last updated: May 9, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 9, 2026, Dec 2, 2025, Jun 21, 2024 (3 updates tracked since 2024).

On this page

About Lerone Evanton Clark Do NPPES

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

LERONE EVANTON CLARK DO (NPI 1457102741) is an individual diagnostic radiology provider in Jacksonville, Florida, licensed in Florida (OS23027) and active in the NPI registry since March 2024. He is enrolled in Medicare PECOS, is affiliated with Mayo Clinic, and is a graduate of New York College Of Osteo Medicine Of New York Institute Of Technology (2024).

NPPES Registry Identity

NPI1457102741

Entity TypeIndividualMale

Primary Taxonomy2085R0202X

Provider Legal NameLERONE EVANTON CLARKCredential: DO

Location Address4500 SAN PABLO RD SJacksonville, FL 32224-1865

Mailing Address4500 San Pablo Rd SJacksonville, FL 32224-1865

Phone(904) 953-2000

Sole ProprietorNo

Medical School CMSNew York College Of Osteo Medicine Of New York Institute Of TechnologyGraduated 2024

Enumeration DateMarch 27, 2024

Last NPPES UpdateMay 9, 20263 updates tracked since enumeration

NPPES CertifiedMay 9, 2026

✔ NPI 1457102741 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians

Taxonomy Code2085R0202X

License✔ Licensed in FL · OS23027

Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

4500 SAN PABLO RD S, Jacksonville, FL 32224

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lerone Evanton Clark Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8224573332

PECOS Enrollment IDI20260702000734

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 Lerone Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mayo Clinic Jacksonville

Same address

Health Service

4500 SAN PABLO RD S
Jacksonville, FL 32224

Reassigned Medicare billing, Florida enrollment
1,828 clinicians in this Medicare group

NPI 1174143986 (904) 953-2000

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

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mayo Clinic

Acute Care Hospitals · Jacksonville, FL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100151

Location4500 San Pablo RdJacksonville, FL 32224 · Duval County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32224 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

$70.04 typical visit price

range $17.57 – $139.16

Typical copayment $17.51 (range $4.39 – $34.79)

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 20

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

KATHERINE L WALSH PA-C/MPH

Physician Assistant