Kalee Emily Hartman, PA-C
Individual provider Active NPI Medical Physician Assistant · Milan, IL
NPI 1093378093 · NPPES record last updated Jan 27, 2023
Key facts
- NPI
- 1093378093
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 085.007038 (IL)
- Practice address
- 1929 10TH Ave E
Milan, IL 61264-2953 - Phone
- (309) 787-2600
- NPI assigned
- Apr 16, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Iowa Physicians Clinic Medical Foundation
Practice addresses (Care Compare)
3904 16TH St
Moline, IL 61265-1275
3912 16TH St
Moline, IL 61265-1275
Phone (309) 581-7600
3924 16TH St
Moline, IL 61265-1275
Phone (309) 779-5260
600 N College Ave
Suite 120
Geneseo, IL 61254-1095
Phone (309) 944-5342
Hospital & facility affiliations
- Unity Point at Home
- Trinity Rock Island
- Trinity - Bettendorf
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190607001017 | IL | Practitioner - Physician Assistant | 0941533814 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085.007038 | IL | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iowa Physicians Clinic Medical Foundation | Current |
Accepting new patients | |
| St Luke'S Methodist Hospital | Current | Accepting new patients | |
| Advanced Radiology, S.C. | Past | Accepting new patients |
Locations
600 N College Ave
Ste 120
Geneseo, IL 61254
Phone (309) 944-5342
3904 16th St
Ste A
Moline, IL 61265
Phone (309) 581-7620
3912 16th St
Moline, IL 61265
Phone (309) 581-7600
Interoperability endpoints
- khartman584467@direct.unitypoint.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 085.007038 | IL | Yes |
Addresses
Primary practice location
1929 10TH Ave E
Milan, IL 61264-2953
Mailing address
1929 10TH Ave E
Milan, IL 61264-2953
Phone (309) 787-2600
Other providers in Milan, IL
- Ewen Chiropractic LLC
- Susan Emily Ewen
- Andrew Garrison
- William Gutz
- Lacey Elizabeth Hainline I
- Highland Park CVS LLC
- Chelsey Marie Hogan
- James L. Hudson
- Hy-Vee Inc
- Quinn L Judge
All providers in Milan, IL · Medical Physician Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.