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TRACY M HAZELTON PA-C
NPI 1821024746
Physician Assistant - Medical in Clearlake, CA

Active since June 23, 2006PECOS Enrolled
78.28/100
CMS Quality Rating
14440 OLYMPIC DRIVE, CLEARLAKE, CA 95422(707) 263-8383(707) 263-5019 Get Directions Write a Review

NPPES record last updated: August 1, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Tracy M Hazelton Pa-c NPPES

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

TRACY M HAZELTON PA-C (NPI 1821024746) is an individual medical provider in Clearlake, California, licensed in California (PA13690) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS, maintains a secondary practice location in Lakeport, and is a graduate of Stanford University School Of Medicine (1996).

NPPES Registry Identity

NPI1821024746
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameTRACY M HAZELTONCredential: PA-C
Location Address14440 OLYMPIC DRIVEClearlake, CA 95422-8809
Mailing AddressPo Box 1950Lakeport, CA 95453-1950 · (707) 263-8382 · Fax (707) 263-1909
Phone(707) 263-8383
Fax(707) 263-5019
Sole ProprietorNo
Medical School CMSStanford University School Of MedicineGraduated 1996
Enumeration DateJune 23, 2006
Last NPPES UpdateAugust 1, 2025
NPPES CertifiedAugust 1, 2025
✔ NPI 1821024746 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in CA · PA13690
14440 OLYMPIC DRIVE, Clearlake, CA 95422
Open in Google Maps ↗

Secondary Practice Location 1

Location 1925 Bevins CourtLakeport, CA 95453-9754 · Phone (707) 263-8383 · Fax (707) 263-5019

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tracy M Hazelton Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2264441393
PECOS Enrollment IDI20060418000211
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 Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

78.28/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality71.31
Promoting Interoperability93
Improvement Activities40
Cost45.47

Referred Medical Equipment & Supplies CMS DME claims 12

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
3 suppliers37 claims74 services$6.13 avg. paid by Medicare
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003
DME-Other DME · category DE000N
1 supplier12 claims22 services$1.65 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
1 supplier11 claims63 services$18.96 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
1 supplier13 claims13 services$68.91 avg. paid by Medicare
Tubing used with positive airway pressure device A7037
DME-Other DME · category DE001N
2 suppliers13 claims13 services$22.62 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
2 suppliers14 claims81 services$3.22 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

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

LAKE COUNTY TRIBAL HEALTH SOUTHSHORE CLINIC
Clinic/Center (Federally Qualified Health Center (FQHC))
14440 OLYMPIC DRIVE
CLEARLAKE, CA 95422
Lake County (707) 263-8382
SOUTHSHORE TRIBAL HEALTH PHARMACY
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
14440 OLYMPIC DRIVE, SUITE B
CLEARLAKE, CA 95422
Lake County (707) 263-8382
SIAMAK SAHAND DMD
Dentist
14440 OLYMPIC DRIVE
CLEARLAKE, CA 95422
Lake County (707) 263-8383

Frequently 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 Tracy Hazelton's NPI number?

The NPI number for Tracy Hazelton is 1821024746. It was assigned to this individual provider in the NPPES registry on June 23, 2006.

Where is Tracy Hazelton located?

Tracy Hazelton practices at 14440 Olympic Drive, Clearlake, CA 95422. The listed phone number is (707) 263-8383.

What is Tracy Hazelton's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Tracy Hazelton enrolled in Medicare?

Yes. Tracy Hazelton is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Tracy Hazelton was last updated on August 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.