NPIMap

Individual provider Active NPI

Hannah K. Newcomb, PA-C

  • Physician Assistant
  • Coon Rapids, MN
National Provider Identifier
1073581195
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9764 Issued in MN
Practice address
3833 Coon Rapids Blvd NW Ste 100
Coon Rapids, MN 55433-2697
Phone
(763) 427-8320
Fax
(763) 302-4338
NPI assigned
Mar 14, 2006
Last updated
Dec 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9764 MN Primary

Addresses

Primary practice location

3833 Coon Rapids Blvd NW Ste 100
Coon Rapids, MN 55433-2697

Mailing address

3833 Coon Rapids Blvd NW Ste 100
Coon Rapids, MN 55433-2697
Phone (763) 427-8320

Other identifiers 1

IdentifierTypeStateIssuer
122800500MedicaidMN

Other names 1

  • Hannah Wilhelm Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040609000203 MN Practitioner - Physician Assistant 8224011531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minneapolis Clinic of Neurology LTDGroup PAC ID 5496668659, 75 clinicians

Practice addresses (Care Compare)

3833 Coon Rapids Blvd NW
Suite 100
Coon Rapids, MN 55433-2697
Phone (763) 427-8320

4225 Golden Valley Rd
Golden Valley, MN 55422-4215
Phone (763) 588-0661

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9764MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Partners in Pediatrics, LTD. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: hnewcomb211042@direct.northmemorial.com

Organizations & group practices 2

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

Hospital & facility affiliations 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1073581195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3833 COON RAPIDS BLVD NW STE 100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332697",
            "telephone_number": "763-427-8320",
            "fax_number": "763-302-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3833 COON RAPIDS BLVD NW STE 100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332697",
            "telephone_number": "763-427-8320",
            "fax_number": "763-302-4338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWCOMB",
        "first_name": "HANNAH",
        "middle_name": "K.",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122800500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HANNAH",
            "last_name": "WILHELM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.