CLEAR LAKE PEDIATRIC CLINIC, P.A.
NPI 1619183936
Pediatrics in Webster, TX
About Clear Lake Pediatric Clinic, P.a. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CLEAR LAKE PEDIATRIC CLINIC, P.A. (NPI 1619183936) is a healthcare organization registered as a pediatrics in Webster, Texas and active in the NPI registry since May 2007. The organization lists Michelle M Cook, Business Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Clear Lake Pediatric Clinic, P.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by October 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to Clear Lake Pediatric Clinic, P.A., which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.
Clinicians, nearest first (5)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 45D0959698
Clear Lake Pediatric Clinic, PA · Webster, TXFrequently 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 Clear Lake Pediatric Clinic, P.A.'s NPI number?
The NPI number for Clear Lake Pediatric Clinic, P.A. is 1619183936. It was assigned to this organization in the NPPES registry on May 15, 2007.
Where is Clear Lake Pediatric Clinic, P.A. located?
Clear Lake Pediatric Clinic, P.A. is located at 16 Professional Park Dr, Webster, TX 77598. The listed phone number is (281) 332-3503.
What is Clear Lake Pediatric Clinic, P.A.'s specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Clear Lake Pediatric Clinic, P.A. enrolled in Medicare?
Yes. Clear Lake Pediatric Clinic, P.A. is registered in the Medicare PECOS enrollment system.
When is Clear Lake Pediatric Clinic, P.A.'s Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Texas, Clinic/Group Practice) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Clear Lake Pediatric Clinic, P.A.?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians, all in Pediatric Medicine, reassign their Medicare billing to Clear Lake Pediatric Clinic, P.A.. A 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 the clinician's services. Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Clear Lake Pediatric Clinic, P.A. was last updated on August 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Clear Lake Pediatric Clinic, P.a. · NPI 1619183936
Pediatrics organization in Webster, Texas. Organization record, active in the CMS NPPES registry since May 15, 2007.
## Identity
- **NPI:** 1619183936 (Entity type: Organization)
- **Enumerated:** May 15, 2007
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **Organization subpart:** No
- **Authorized official:** Michelle Cook, BUSINESS MANAGER
## Practice location
- **Address:** 16 PROFESSIONAL PARK DR, Webster, TX 77598-4127
- **Phone:** (281) 332-3503 · **Fax:** (201) 849-7650
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** October 31, 2026 (Non-DME Part B, Texas, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 5 clinicians (Pediatric Medicine) reassign Medicare billing to this organization (form CMS-855R); 4 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 19, 2025
- **Other identifiers:** Medicaid 0843393-01 (TX)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1619183936) · Data from the CMS NPPES public registry.