ADVENTIST HEALTH CLEARLAKE HOSPITAL INC.
NPI 1124018031
General Acute Care Hospital - Critical Access in Clearlake, CA
About Adventist Health Clearlake Hospital Inc. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ADVENTIST HEALTH CLEARLAKE HOSPITAL INC. (NPI 1124018031), doing business as Adventist Health Clear Lake, is a healthcare organization registered as a critical access in Clearlake, California and active in the NPI registry since October 2005. The organization holds an CLIA Accreditation certificate valid through January 2, 2027 and lists Parker J Pridgen, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 3
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Adventist Health Clearlake Hospital Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
182Medicare enrollment records show 182 clinicians reassign Medicare billing to Adventist Health Clearlake Hospital Inc., which bills Medicare for the services they deliver. Of these, 4 practice at this address and 32 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 30
Nearest to this location (20)
See all 182Clearlake, CA 95422
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Accreditation 05D0611927
Adventist Health Clear Lake · Clearlake, CAFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Adventist Health Clearlake Hospital Inc.'s NPI number?
The NPI number for Adventist Health Clearlake Hospital Inc. is 1124018031. It was assigned to this organization in the NPPES registry on October 24, 2005. The provider is doing business as Adventist Health Clear Lake.
Where is Adventist Health Clearlake Hospital Inc. located?
Adventist Health Clearlake Hospital Inc. is located at 15630 18th Ave, Clearlake, CA 95422. The listed phone number is (707) 994-6486.
What is Adventist Health Clearlake Hospital Inc.'s specialty?
The primary specialty registered for this NPI is General Acute Care Hospital, specializing in Critical Access, with taxonomy code 282NC0060X.
Is Adventist Health Clearlake Hospital Inc. enrolled in Medicare?
Yes. Adventist Health Clearlake Hospital Inc. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Adventist Health Clearlake Hospital Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 182 clinicians in 30 Medicare specialties reassign their Medicare billing to Adventist Health Clearlake Hospital Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Diagnostic Radiology (54), Nurse Practitioner (34) and Clinical Social Worker (21). Of these, 4 practice at this address and 32 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Adventist Health Clearlake Hospital Inc. hold a CLIA laboratory certificate?
Yes. A Certificate of Accreditation (number 05D0611927) is associated with this NPI, valid through January 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Adventist Health Clearlake Hospital Inc. was last updated on September 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Adventist Health Clearlake Hospital Inc. · NPI 1124018031
Critical Access organization in Clearlake, California. Organization record, active in the CMS NPPES registry since October 24, 2005.
## Identity
- **NPI:** 1124018031 (Entity type: Organization)
- **Enumerated:** October 24, 2005
- **Primary specialty:** General Acute Care Hospital - Critical Access · taxonomy 282NC0060X
- **Also known as:** Adventist Health Clear Lake (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Parker Pridgen, PRESIDENT
## Practice location
- **Address:** 15630 18TH AVE, Clearlake, CA 95422-6710
- **Phone:** (707) 994-6486 · **Fax:** (707) 995-3631
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 182 clinicians in 30 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Diagnostic Radiology (54), Nurse Practitioner (34), Clinical Social Worker (21); 4 practice at this address and 32 within 10 miles; [full list](https://npiprofile.com/npi/1124018031/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 15, 2025
- **Other identifiers:** Medicaid HSP40539G (CA); Other ZZZC1702Z (CA); Medicaid ZZR00539G (CA)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1124018031) · Data from the CMS NPPES public registry.