Alicia Suzanne Clark, MPAP, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

51943 Issued in CA

Practice address

123 S Alvarado St
Los Angeles, CA 90057-2201

Phone

(213) 989-7700

NPI assigned

Mar 25, 2014

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 names 1

• Ms. Alicia Suzanne Perez Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Anchor Medical Group

  • Family Medicine Physician
  • Yorba Linda, CA
  • NPI 1700678810

  CA

  Medicare reassignment NPD
• Caduceus Physicians Medical Group

  • Family Medicine Physician
  • Yorba Linda, CA
  • NPI 1497702724

  CA

  Medicare reassignment

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

{
    "created_epoch": "1395705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432166400000",
    "number": "1669899985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 S ALVARADO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572201",
            "telephone_number": "213-989-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 S ALVARADO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572201",
            "telephone_number": "213-989-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ALICIA",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "credential": "MPAP, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-25",
        "last_updated": "2015-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "51943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "PEREZ",
            "middle_name": "SUZANNE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Maurisa Lorrene Clark-Hallums
• Stacy Clark-Huffman
• Cynthia Clark-Lyles, MA
• Abigail Clark
• Ahyana Clark
• Amara Candace Clark
• Andrew Clark, MD, PHD
• Anna Clark, M.A., CCC-SLP
• Barbara Latrease Clark, PA-C
• Bonnie Marie Clark

• All providers in Los Angeles, CA
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.