Ana L Pacheco Clark, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G62400 Issued in CA

Practice address

4700 Hoen Ave
Santa Rosa, CA 95405-7824

Phone

(707) 526-3360

Fax

(707) 526-0554

NPI assigned

Jun 9, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of California, San Francisco School of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sutter Care at Home Home health agency, Santa Rosa, CA, CCN 058189
• California Pacific Medical Ctr-Davies Campus Hosp Hospital, San Francisco, CA, CCN 050008
• Sutter Santa Rosa Regional Hospital Hospital, Santa Rosa, CA, CCN 050291
• Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: apachecoclark41839@hisp.ehr.sutterhealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sutter Bay Medical Foundation

  • Multi-Specialty Clinic/Center
  • Palo Alto, CA
  • NPI 1013950807
  Medicare reassignment Care Compare group NPD
• Sutter Bay Medical Foundation

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
  • NPI 1003267196

  Family Medicine

  NPD
• Sutter Bay Medical Foundation

  • Clinical Medical Laboratory
  • Santa Clara, CA
  • NPI 1669287033
  NPD
• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  NPD (past)
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1740413798
  NPD (past)
• Sutter East Bay Medical Foundation

  • Family Medicine Physician
  • Orinda, CA
  • NPI 1871538769
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • San Francisco, CA
  • NPI 1659439834
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1740413798
  Care Compare affiliation
• Sutter Visiting Nurse Association and Hospice

  • Home Health Agency
  • Santa Rosa, CA
  • NPI 1205865870
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1053352948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 HOEN AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954057824",
            "telephone_number": "707-526-3360",
            "fax_number": "707-526-0554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 HOEN AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954057824",
            "telephone_number": "707-526-3360",
            "fax_number": "707-526-0554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHECO CLARK",
        "first_name": "ANA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G62400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G624000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leigh A. Owyang, O.D.
• Oxford Care LLC
• Jessica Ozbirn
• Cheryl A Pabros, LVN
• Sari Lynne Pace
• Maria V Pacheco, N.P.
• Susana Pacheco
• Tema Hlynn Pacheco, RN
• Pacific Medical, Inc.
• Sarah Pack

• Family Medicine Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.