DR. OMAR-SHAY CLARK DC
NPI 1457895351
Chiropractor in Cape Coral, FL
About Dr. Omar-shay Clark Dc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. OMAR-SHAY CLARK DC (NPI 1457895351) is an individual chiropractor in Cape Coral, Florida, licensed in Florida (CH11971) and active in the NPI registry since December 2016. He is a graduate of Other (2016).
NPPES Registry Identity
Specialties & Licenses
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. Omar-shay Clark Dc 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.
Medicare Billing Reassignment
Medicare enrollment records show Omar-shay Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Cape Coral, FL 33991
- Reassigned Medicare billing, Florida enrollment
- 3 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Omar-shay Clark's NPI number?
The NPI number for Omar-shay Clark is 1457895351. It was assigned to this individual provider in the NPPES registry on December 12, 2016.
Where is Omar-shay Clark located?
Omar-shay Clark practices at 2378 Surfside Blvd Suite A133, Cape Coral, FL 33991. The listed phone number is (239) 205-3700.
What is Omar-shay Clark's specialty?
The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.
Is Omar-shay Clark enrolled in Medicare?
Yes. Omar-shay 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 organization bills Medicare for Omar-shay Clark's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Omar-shay Clark reassigns Medicare benefits to Experience Family Chiropractic (Cape Coral, FL). 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 Omar-shay Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Omar-shay Clark was last updated on December 12, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Dr. Omar-Shay Clark, DC · NPI 1457895351
Chiropractor provider in Cape Coral, Florida. Individual provider, active in the CMS NPPES registry since December 12, 2016.
## Identity
- **NPI:** 1457895351 (Entity type: Individual)
- **Enumerated:** December 12, 2016
- **Primary specialty:** Chiropractor · taxonomy 111N00000X
- **State license:** CH11971 (Florida)
- **Sole proprietor:** No
## Practice location
- **Address:** 2378 SURFSIDE BLVD, SUITE A133, Cape Coral, FL 33991-3181
- **Phone:** (239) 205-3700
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** Experience Family Chiropractic (NPI 1447794342, Cape Coral, FL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2016
## Record status
- **NPPES last updated:** December 12, 2016
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Source: [NPI Profile](https://npiprofile.com/npi/1457895351) · Data from the CMS NPPES public registry.