Tracy M Hazelton, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA13690 Issued in CA

Practice address

14440 Olympic Drive
Clearlake, CA 95422-8809

Phone

(707) 263-8383

Fax

(707) 263-5019

NPI assigned

Jun 23, 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

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

Specialty

Physician Assistant

Education

Stanford University School of Medicine, 1996

Medicare assignment

May accept Medicare assignment

Group practices

Lake County Tribal Health Consortium IncGroup PAC ID 8729975545, 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health Home Care Services Home health agency, Lower Lake, CA, CCN 057710
• Adventist Health Clearlake Hospital, Clearlake, CA, CCN 051317
• Sutter Lakeside Hospital Hospital, Lakeport, CA, CCN 051329

Merit-based Incentive Payment System (MIPS)

Final score

90.74 of 100Reported as group

Quality

94

Promoting interoperability

92

Improvement activities

40

Cost

65.12

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tracy.hazelton.p1@direct.lcthc.nextgenshare.com

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.

• Lake County Tribal Health Consortium Inc.

  • Federally Qualified Health Center (FQHC)
  • Lakeport, CA
  • NPI 1881697381

  CA

  Medicare reassignment Care Compare group NPD
• Acute Medical Providers - Inpatient Inc.

  • Hospitalist Physician
  • Saint Helena, CA
  • NPI 1679080311
  NPD (past)
• Acute Medical Providers, Inc.

  • Emergency Medicine Physician
  • Saint Helena, CA
  • NPI 1942571146
  NPD (past)

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

• Adventist Health Clearlake Hospital Inc.

  • Critical Access Hospital
  • Clearlake, CA
  • NPI 1124018031

  Hospital

  Care Compare affiliation
• Sutter Bay Hospitals

  • Critical Access Hospital
  • Lakeport, CA
  • NPI 1952634008

  Hospital

  Care Compare affiliation
• Western Health Resources

  • Home Health Agency
  • Lower Lake, CA
  • NPI 1063762896
  Care Compare affiliation

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1821024746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1950",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954531950",
            "telephone_number": "707-263-8382",
            "fax_number": "707-263-1909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14440 OLYMPIC DRIVE",
            "city": "CLEARLAKE",
            "state": "CA",
            "postal_code": "954228809",
            "telephone_number": "707-263-8383",
            "fax_number": "707-263-5019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 Bevins Court",
            "address_purpose": "LOCATION",
            "city": "Lakeport",
            "state": "CA",
            "postal_code": "954539754",
            "country_code": "US",
            "telephone_number": "707-263-8383",
            "fax_number": "707-263-5019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAZELTON",
        "first_name": "TRACY",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA13690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shichang Hao, MD
• Debra Kay Harding
• Stephenie Hargrove, NP
• Veronica Harrison, LCSW
• Barbara J Harrold, PHD
• Kirsten Marie Hendrix, RBT
• John Hewitt, MD
• Thomas Hewlett, DDS
• Amanda Gay Hicks
• Highlands Senior Service Center, Inc

• All providers in Clearlake, CA
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2025; 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.