Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1104399849 Individual Practitioner Female Practitioner

Demetria Angelica Clark , PA

Physician Assistant • Jacksonville, FL

Professional Overview & Biography Verified Profile Summary

Demetria Clark, PA is a registered healthcare professional specializing in Physician Assistant in Jacksonville, FL. Practice services are available at 4500 SAN PABLO RD S under active NPI credentials.

Frequently performed procedures and clinical services include hospital discharge day management, more than, initial hospital care with moderate level of medical decision making, if using time, at least, established patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

4500 San Pablo Rd S

Jacksonville, FL 322241865

Telephone 9049532000
Fax 9049560381
Associated Practice Facility / Clinic
🏢 Mayo Clinic Jacksonville Facility NPI 1790772317

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Jacksonville, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 11.2 Yrs
State Avg: 11.1 Yrs
Regional Practice Density
844 Specialists

Practicing in Jacksonville, FL (10376 Statewide)

Telehealth Adoption Rate
20.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
15.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2021)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99239 Hospital discharge day management, more than 30 minutes
18 16 $103.95 $88.36
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes
11 11 $194.69 $165.49

Medical Specialties & State Licenses

CMS Verified: 2023-12-21
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License FL PA9114358

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.

Physician Assistant

NUCC Taxonomy Code: 363A00000X

State License MN 12918

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Katherine Walsh , PA-C, MPH

Physician Assistant

NPI 1003015280

Physician Assistant (Certified), Master of Public Health

Dr. Jami Kinnucan , MD

Internal Medicine - Gastroenterology

NPI 1003045634

Doctor of Medicine (M.D.)

Dr. Glenn Shi , MD

Orthopaedic Surgery

NPI 1003058660

Doctor of Medicine (M.D.)

Dr. Michelle Tulang , MD

Internal Medicine

NPI 1003073586

Doctor of Medicine (M.D.)

NPI 1003100520

Doctor of Medicine (M.D.)

Crystal Lynn , CRNA

Nurse Anesthetist, Certified Registered

NPI 1003148768

Certified Registered Nurse Anesthetist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
📍
Updated Practice Location December 21, 2023

Registered at 4500 SAN PABLO RD S, JACKSONVILLE, FL 322241865 (Tel: 9049532000)

📍
Updated Business Mailing Address June 13, 2022

Registered at 200 1ST ST SW, ROCHESTER, MN 559050001 (Tel: 5072842511)

📍
Updated Business Mailing Address September 24, 2021

Registered at 4500 SAN PABLO RD S, JACKSONVILLE, FL 322241865 (Tel: 9049532000)

📍
Updated Business Mailing Address February 14, 2019

Registered at 200 1ST ST SW, ROCHESTER, MN 559050001 (Tel: 5072842511)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 14, 2019

Physician Assistant (License #12918 in MN)

NPI Profile Active January 04, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location January 04, 2019

Registered at 200 1ST ST SW, ROCHESTER, MN 559050001 (Tel: 5072842511)

📍
Updated Business Mailing Address January 04, 2019

Registered at 307 HAW CREEK MEWS DR, ASHEVILLE, NC 288051961 (Tel: 1828691135)

👤
Provider Name / Credentials Updated January 04, 2019

Recorded as DEMETRIA CLARK, PA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 04, 2019

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration January 04, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104399849
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 04, 2019
Last Update: December 21, 2023
Sole Proprietor: No

Mailing Address

200 1st St Sw

Rochester, MN 559050001

Phone: 5072842511

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.