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ANGELICA CLARK PA-C
NPI 1932468659
Physician Assistant in Gatesville, TX

Active since May 15, 2012Opted out of Medicare · through Oct 1, 2026
227 MEMORIAL DR, GATESVILLE, TX 76528(254) 248-6500 Get Directions Write a Review

NPPES record last updated: May 15, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Angelica Clark Pa-c NPPES

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

ANGELICA CLARK PA-C (NPI 1932468659) is an individual physician assistant in Gatesville, Texas, licensed in Texas (PA05932) and active in the NPI registry since May 2012. She has opted out of Medicare through October 1, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1932468659
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameANGELICA CLARKCredential: PA-C
Location Address227 MEMORIAL DRGatesville, TX 76528-1028
Mailing AddressPo Box 847408Dallas, TX 75284-7408 · (254) 724-8800
Phone(254) 248-6500
Sole ProprietorNo
Enumeration DateMay 15, 2012
✔ NPI 1932468659 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in TX · PA05932
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
227 MEMORIAL DR, Gatesville, TX 76528
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Opted out of Medicare

Angelica Clark Pa-c has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2014 through October 1, 2026.

Opt-Out Effective DateOctober 1, 2014
Opt-Out In Effect ThroughOctober 1, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76528 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
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
Most-billed visit code 99213
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

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

KERI TATUM FNP
Nurse Practitioner (Family)
227 MEMORIAL DR
GATESVILLE, TX 76528
Coryell County (254) 248-6500

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 Angelica Clark's NPI number?

The NPI number for Angelica Clark is 1932468659. It was assigned to this individual provider in the NPPES registry on May 15, 2012.

Where is Angelica Clark located?

Angelica Clark practices at 227 Memorial Dr, Gatesville, TX 76528. The listed phone number is (254) 248-6500.

What is Angelica Clark's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Angelica Clark enrolled in Medicare?

No. Angelica Clark has opted out of Medicare through October 1, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Angelica Clark was last updated on May 15, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years 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.