Vanessa Christina Clark, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085.006689 Issued in IL

Practice address

1135 116TH Ave NE Ste 500
Bellevue, WA 98004-4627

Phone

(425) 635-6560

Fax

(425) 637-3210

NPI assigned

Aug 29, 2018

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 3

Other names 1

• Vanessa Chrisitna Castor Former name

Medicare fee-for-service enrollment

Enrolled in WA

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

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Swedish Health ServicesGroup PAC ID 0244138196, 1,038 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Swedish Medical Center Hospital, Seattle, WA, CCN 500027

Merit-based Incentive Payment System (MIPS)

Final score

87.1 of 100Reported as group

Quality

84.53

Promoting interoperability

100

Improvement activities

40

Cost

72.46

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vclark2849063@wm.providencedirect.org

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.

• Swedish Health Services

  • Internal Medicine Physician
  • Seattle, WA
  • NPI 1689612954
  Medicare reassignment Care Compare group NPD
• King County Public Hospital District No 2

  dba Booth Gardner Parkinsons Care Center

  • Neuromusculoskeletal Medicine & OMM Physician
  • Kirkland, WA
  • NPI 1801986070
  Medicare reassignment
• Overlake Medical Clinics, LLC

  • Specialist
  • Bellevue, WA
  • NPI 1801828421
  Medicare reassignment
• King County Public Hospital District No 2

  dba EvergreenHealth Medical Group Pro Fees

  • Internal Medicine Physician
  • Kirkland, WA
  • NPI 1467542639
  NPD
• King County Public Hospital District No. 2

  dba EvergreenHealth at Home Physical Therapy

  • Physical Therapist
  • Kirkland, WA
  • NPI 1356920946
  NPD
• Overlake Medical Clinics LLC

  • Specialist
  • Bellevue, WA
  • NPI 1871745703
  NPD
• Swedish Health Services

  dba Swedish Physician Division

  • Surgery Physician
  • Seattle, WA
  • NPI 1053368571
  NPD (past)

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

• Swedish Health Services

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1306992151
  Care Compare affiliation

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

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1932681764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 116TH AVE NE STE 500",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044627",
            "telephone_number": "425-635-6560",
            "fax_number": "425-637-3210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 116TH AVE NE STE 500",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044627",
            "telephone_number": "425-635-6560",
            "fax_number": "425-637-3210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Biesterfield Rd Ste 610",
            "address_purpose": "LOCATION",
            "city": "Elk Grove Village",
            "state": "IL",
            "postal_code": "600073362",
            "country_code": "US",
            "telephone_number": "847-981-3630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "VANESSA",
        "middle_name": "CHRISTINA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-29",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "61100713",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.006689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT LICENSE",
            "identifier": "085.006689",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT LICENSE",
            "identifier": "61100713",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1151434",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VANESSA",
            "last_name": "CASTOR",
            "middle_name": "CHRISITNA",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mark Eldon Clark
• Michael Clark, OTR/L
• Nancy L Clark, PA-C
• Robert Leon Clark, MD
• Shauna Clark, RN
• Clark's Pharmacy Inc
• Megan Clarke, MA, LMFTA
• Margaret Clarkson
• Ivone Claros-Carvalho, L.M.P.
• William Clave, D.M.D

• Physician Assistant in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; 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.