Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Candace Ann Clark, PA

Individual provider Physician Assistant · NPI 1376166579

Candace Ann Clark, PA is a Physician Assistant in Milwaukee, Wisconsin. Qualified in 2020, 6 years ago. Practices with The Medical College of Wisconsin Inc, a 2,093-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Wisconsin.

Years since qualifying
6
Licensed in
WI
In the registry since
2020
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone: (414) 805-8710
Fax: (414) 805-1101
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5185 (WI)

Record details

NPI number1376166579
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 21, 2020
Last updated in NPPESApril 22, 2022
Certification dateApril 22, 2022
Mailing address9200 W Wisconsin Ave, Milwaukee, WI 53226-3522

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice The Medical College Of Wisconsin Inc — 2093 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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