Amizetta Carol Clark, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A175677 Issued in CA

Practice address

10 Woodland Rd
Saint Helena, CA 94574-9554

Phone

(707) 963-3611

NPI assigned

May 13, 2016

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 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

PsychiatryAlso: Internal Medicine

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. Helena HospitalGroup PAC ID 8729059878, 85 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health St Helena Hospital, Saint Helena, CA, CCN 050013

Merit-based Incentive Payment System (MIPS)

Final score

85.91 of 100Reported as group

Quality

75.49

Promoting interoperability

94

Improvement activities

40

Cost

73.96

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St. Helena Hospital

  dba Adventist Health St. Helena

  • General Acute Care Hospital
  • Saint Helena, CA
  • NPI 1720078082
  Medicare reassignment Care Compare group NPD
• Adventist Health Physicians Network

  • Multi-Specialty Clinic/Center
  • Hanford, CA
  • NPI 1063718583
  Medicare reassignment NPD
• Salus Medical Collective, a Professional Corporation

  dba Salus Medical Collective

  • Psychiatry Physician
  • Saint Helena, CA
  • NPI 1477440493

  Internal Medicine

  NPD Authorized official
• Adventist Health Physicians Network

  • Physical Therapy Clinic/Center
  • Paradise, CA
  • NPI 1134092190
  NPD
• Adventist Health Physicians Network

  • Surgery Physician
  • Saint Helena, CA
  • NPI 1235564170
  NPD
• St. Helena Hospital

  dba Adventist Health Vallejo

  • Psychiatric Hospital
  • Vallejo, CA
  • NPI 1851381990
  NPD

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

• St. Helena Hospital

  dba Adventist Health St. Helena

  • General Acute Care Hospital
  • Saint Helena, CA
  • NPI 1720078082
  Care Compare affiliation

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

{
    "created_epoch": "1463097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1841646353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 WOODLAND RD",
            "city": "SAINT HELENA",
            "state": "CA",
            "postal_code": "945749554",
            "telephone_number": "808-287-8496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 WOODLAND RD",
            "city": "SAINT HELENA",
            "state": "CA",
            "postal_code": "945749554",
            "telephone_number": "707-963-3611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Stantonsburg Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278342818",
            "country_code": "US",
            "telephone_number": "252-744-2393",
            "fax_number": "252-744-0013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "AMIZETTA",
        "middle_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-13",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A175677",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A175677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A175677",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "clarka05@ah.org",
            "affiliation": "N",
            "address_1": "10 Woodland Rd",
            "city": "Saint Helena",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945749554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Psychiatry Physician in Saint Helena, CA
• Providers in Saint Helena, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.