Individual provider Active NPI

Annie Penquite Hamilton, PA-C

  • Physician Assistant
  • Pleasant Hill, IA
National Provider Identifier
1013544667
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
101949 Issued in IA
Practice address
5900 E University Ave Ste 100
Pleasant Hill, IA 50327-8467
Phone
(515) 643-2400
Fax
(515) 643-4766
NPI assigned
Mar 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 101949 IA Primary

Addresses

Primary practice location

5900 E University Ave Ste 100
Pleasant Hill, IA 50327-8467

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 643-2400

Other names 1

  • Annie Lorraine Penquite Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200728003222 IA Practitioner - Physician Assistant 6305261090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinics IncGroup PAC ID 7911810882, 441 clinicians

Practice addresses (Care Compare)

1755 59TH PL
West Des Moines, IA 50266-7737
Phone (515) 247-4240

330 Laurel St
Suite 1200
Des Moines, IA 50314-3044
Phone (515) 643-6290

5900 E University Ave
Pleasant Hill, IA 50327-8467

5900 E University Ave
100 Mercyone Pleasant Hill Fam Med Clinic/U
Pleasant Hill, IA 50327-8457
Phone (515) 643-2400

800 E 1St St
Ankeny, IA 50021-2077

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
101949IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinics, Inc. CurrentSince Jun 5, 2023 Accepting new patients
Mercy Clinics Inc CurrentSince Jun 5, 2023 Accepting new patients

Locations

330 Laurel St
Ste 1200
Des Moines, IA 50314
Phone (515) 643-5454

405 SW 5th St
Ste E
Des Moines, IA 50309
Phone (515) 358-7259

5900 E University Ave
Ste 100
Pleasant Hill, IA 50327
Phone (515) 643-2400

Interoperability endpoints

  • Direct secure messaging: ahamilton3946050@direct.trinity-health.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1013544667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503051475",
            "telephone_number": "515-643-2400",
            "fax_number": "515-643-4766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 E UNIVERSITY AVE STE 100",
            "city": "PLEASANT HILL",
            "state": "IA",
            "postal_code": "503278467",
            "telephone_number": "515-643-2400",
            "fax_number": "515-643-4766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "ANNIE",
        "middle_name": "PENQUITE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-24",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "101949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNIE",
            "last_name": "PENQUITE",
            "middle_name": "LORRAINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pleasant Hill, IA

Sources for this page

Verify at the official NPI Registry.