MS. MARY ANGELYN JOVES CLARK MSN, APRN
NPI 1053887455
Nurse Practitioner in Walnut Creek, CA

Q: What is Mary Angelyn Clark's NPI number?

The NPI number for Mary Angelyn Clark is 1053887455. It was assigned to this individual provider in the NPPES registry on October 23, 2018.

Q: What is Mary Angelyn Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Active since October 23, 2018PECOS EnrolledAccepts Medicare Assignment

177 LA CASA VIA STE 390, WALNUT CREEK, CA 94598(925) 692-5610 Get Directions Write a Review

NPPES record last updated: October 9, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Oct 9, 2025, Jan 26, 2023, Apr 6, 2020 and 2 more (5 updates tracked since 2018).

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About Ms. Mary Angelyn Joves Clark Msn, Aprn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. MARY ANGELYN JOVES CLARK MSN, APRN (NPI 1053887455) is an individual nurse practitioner in Walnut Creek, California, licensed in California (NP95009579) and active in the NPI registry since October 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1053887455

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameMS. MARY ANGELYN JOVES CLARKCredential: MSN, APRN

Location Address177 LA CASA VIA STE 390Walnut Creek, CA 94598-6101

Mailing Address1450 Treat Blvd Ste 300Walnut Creek, CA 94597-2168 · (925) 952-2828

Phone(925) 692-5610

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateOctober 23, 2018

Last NPPES UpdateOctober 9, 20255 updates tracked since enumeration

NPPES CertifiedOctober 9, 2025

✔ NPI 1053887455 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in CA · NP95009579

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedRegistered NurseTaxonomy 163W00000X · License 95068012 (CA)

Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X · License NP95009579 (CA)

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License NP95009579 (CA)

177 LA CASA VIA STE 390, Walnut Creek, CA 94598

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Mary Angelyn Joves Clark Msn, Aprn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1052644382

PECOS Enrollment IDI20190531000835

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Mary Angelyn Clark reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

John Muir Physician Network

1.1 mi

General Practice

1450 TREAT BLVD, SUITE 300
Walnut Creek, CA 94597

Reassigned Medicare billing, California enrollment
650 clinicians in this Medicare group

NPI 1841407665 (925) 296-9872

Epic Care

14 mi

Multi-Specialty

4721 DALLAS RANCH RD
Antioch, CA 94531

Reassigned Medicare billing, California enrollment
86 clinicians in this Medicare group

NPI 1780107797 (925) 778-0679

Permanente Medical Group Inc

18 mi

Internal Medicine

901 NEVIN
Richmond, CA 94801

Reassigned Medicare billing, California enrollment
20,078 clinicians in this Medicare group

NPI 1235226531 (510) 307-1555

County Of San Joaquin

41 mi

Multi-Specialty

1414 N CALIFORNIA ST SUITE A
Stockton, CA 95202

Reassigned Medicare billing, California enrollment
534 clinicians in this Medicare group

NPI 1083955801 (209) 953-6400

San Joaquin Faculty Medical Group

42 mi

Internal Medicine

500 HOSPITAL RD
French Camp, CA 95231

Reassigned Medicare billing, California enrollment
512 clinicians in this Medicare group

NPI 1225063761 (209) 473-6555

Albion Medical Partners Of California West P C

357 mi

Internal Medicine

12900 PARK PLAZA DR, STE 700, MS-7110
Cerritos, CA 90703

Reassigned Medicare billing, California enrollment
235 clinicians in this Medicare group

NPI 1073110607 (562) 622-2800

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

190 services152 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

118 services98 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94598 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$104.51 typical visit price

range $69.00 – $202.35

Typical copayment $26.12 (range $17.25 – $50.58)

Most-billed visit code 99203

Established Patient

$119.48 typical visit price

range $23.44 – $166.46

Typical copayment $29.87 (range $5.86 – $41.61)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELISE MANZANILLO NP

Nurse Practitioner