Angela M Clark, PA is a medicare enrolled "Physician Assistant - Medical" in Belleville, Wisconsin. Her current practice location is
1121 Bellwest Blvd, Belleville, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(608) 424-3384.
Angela M Clark is licensed to practice in Wisconsin (license number 1497-23) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1235195835.
Provider's Profile
Full Name | Angela M Clark |
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Gender | Female |
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Speciality | Physician Assistant - Medical |
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Location | 1121 Bellwest Blvd, Belleville, Wisconsin |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1235195835
- Provider Enumeration Date: 04/22/2006
- Last Update Date: 11/08/2022
Medicare PECOS Information:
- PECOS PAC ID: 4385775014
- Enrollment ID: I20100624000597
Medical Identifiers
Medical identifiers for Angela M Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1235195835 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363AS0400X | Physician Assistant - Surgical | 1497 (Wisconsin) | Secondary |
363AM0700X | Physician Assistant - Medical | 1497-23 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Angela M Clark is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Angela M Clark, PA 7974 Uw Health Ct, Middleton, WI 53562-5531 Ph: () - | Angela M Clark, PA 1121 Bellwest Blvd, Belleville, WI 53508-9433 Ph: (608) 424-3384 |
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