Individual provider Active NPI

Angela M Clark, PA

  • Medical Physician Assistant
  • Belleville, WI
National Provider Identifier
1235195835
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1497-23 Issued in WI
Practice address
1121 Bellwest Blvd
Belleville, WI 53508-9433
Phone
(608) 424-3384
NPI assigned
Apr 22, 2006
Last updated
Nov 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1497-23 WI Primary
Surgical Physician Assistant 363AS0400X 1497 WI

Addresses

Primary practice location

1121 Bellwest Blvd
Belleville, WI 53508-9433

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address aclarkpa5268@direct.monroeclinic.org Direct
FHIR URL https://webproxyprd.monroeclinic.org/FHIR-PRD/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100624000597 WI Practitioner - Physician Assistant 4385775014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 N Nine Mound Rd
Verona, WI 53593-1032
Phone (608) 287-2770

1001 Nygaard St
Stoughton, WI 53589-5495
Phone (608) 877-2660

1050 E Broadway
Monona, WI 53716-4023
Phone (608) 222-8779

1121 Bellwest Blvd
Belleville, WI 53508-9433
Phone (608) 287-2770

600 Highland Ave
Madison, WI 53792-0001
Phone (608) 263-6400

600 N 8TH St
Mount Horeb, WI 53572-1870
Phone (608) 287-2770

7102 Mineral Point Rd
Madison, WI 53717-1706
Phone (608) 828-7603

7974 Uw Health CT
Middleton, WI 53562-5531

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.32 of 100Reported as group
Quality
87.78
Promoting interoperability
77
Improvement activities
40
Cost
75.8

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1497-23WIMDMedical Physician Assistant
1497WIMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Wisconsin Medical Foundation, Inc CurrentSince Nov 14, 2022 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Nov 14, 2022 Accepting new patients
University of Wisconsin System Non Payroll Past Accepting new patients

Locations

1121 Bellwest Blvd
Belleville, WI 53508
Phone (608) 424-3384

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

7974 Uw Health Ct
Middleton, WI 53562
Phone (608) 829-5270

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

Interoperability endpoints

  • Direct secure messaging: aclarkpa5268@direct.monroeclinic.org

Organizations & group practices 3

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

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1145664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1235195835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 BELLWEST BLVD",
            "city": "BELLEVILLE",
            "state": "WI",
            "postal_code": "535089433",
            "telephone_number": "608-424-3384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ANGELA",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-22",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "1497-23",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WI",
            "license": "1497",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aclarkpa5268@direct.monroeclinic.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "aclarkpa5268@direct.monroeclinic.org",
            "address_1": "2009 5th St",
            "city": "Monroe",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535661546",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://webproxyprd.monroeclinic.org/FHIR-PRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2009 5th St",
            "city": "Monroe",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535661546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Belleville, WI

Sources for this page

Verify at the official NPI Registry.