Drew Siebenmorgen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-669 Issued in AR

Practice address

5500 W 12TH St
Little Rock, AR 72204-1716

Phone

(501) 435-1402

Fax

(501) 232-4210

NPI assigned

May 10, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

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

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Group practices

Oak Street Health Physicians Group of Arkansas PLLCGroup PAC ID 2264893411, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Medical Center North Little Rock Hospital, North Little Rock, AR, CCN 040036
• Baptist Health Medical Center-Little Rock Hospital, Little Rock, AR, CCN 040114

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Oak Street Health Physicians Group of Arkansas PLLC

  • Primary Care Clinic/Center
  • Little Rock, AR
  • NPI 1144917758
  Medicare reassignment Care Compare group
• Arkansas Central Primary Care, PLLC

  • Family Medicine Physician
  • Jacksonville, AR
  • NPI 1396996740
  Medicare reassignment NPD
• Southwest Family Practice PA

  • Family Medicine Physician
  • Little Rock, AR
  • NPI 1275950016
  Medicare reassignment

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

• Baptist Health

  • General Acute Care Hospital
  • Little Rock, AR
  • NPI 1043240682
  Care Compare affiliation
• Baptist Health

  • General Acute Care Hospital
  • North Little Rock, AR
  • NPI 1497790042
  Care Compare affiliation

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

{
    "created_epoch": "1462838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1093161069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746873",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 W 12TH ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722041716",
            "telephone_number": "501-435-1402",
            "fax_number": "501-232-4210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Braden St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "AR",
            "postal_code": "720763719",
            "country_code": "US",
            "telephone_number": "501-985-5934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIEBENMORGEN",
        "first_name": "DREW",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-10",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohammad Saif-Ur-Rehmam Siddiqui, MD
• Sayyadul M Siddiqui, MD
• Shagufta P Siddiqui, MD
• Zainab Siddiqui, MD
• Sidewalk Therapy Group, LLC
• Jacob Siebenmorgen, MD, MPH
• Brian Sieczkowski, P.T.
• Madison Siems, M.S., CF-SLP
• Martin L Siems, M.D.
• Anthony Ray Sierra I, CRNA

• Physician Assistant in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Physician Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.