Pamela A Hansen, PA-C
Individual provider Active NPI Physician Assistant · Mendota, IL
NPI 1245306166 · NPPES record last updated Apr 13, 2009
Key facts
- NPI
- 1245306166
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 085-000486 (IL)
- Practice address
- 1315 Memorial Dr
Mendota, IL 61342-1447 - Phone
- (815) 539-1422
- Fax
- (815) 539-1436
- NPI assigned
- Nov 24, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- University of Nebraska College of Medicine, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Osf Multi-Specialty Group
Practice addresses (Care Compare)
1100 E Norris Dr
Ottawa, IL 61350-1604
Phone (815) 433-3100
1401 E 12TH St
Mendota, IL 61342-9216
Phone (815) 227-5600
1614 E Norris Dr
OBGYN and Anti Coag
Ottawa, IL 61350-3681
Phone (815) 431-0435
8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050
Hospital & facility affiliations
- Osf Saint Elizabeth MDL Ctr
- Osf Saint Paul Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.78 of 100
- Quality
- 80.38
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IL, ND
- 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 |
|---|---|---|---|---|
| I20040511000534 | IL | Practitioner - Physician Assistant | 3274522693 | Reassigns benefits to 1 organization |
| I20230703001889 | ND | Practitioner - Physician Assistant | 3274522693 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085-000486 | IL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Osf Multi-Specialty Group | Current |
Accepting new patients | |
| Lutheran Charity Association | Current |
Accepting new patients | |
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Mendota Community Hospital | Past | Accepting new patients | |
| Cardinal Medical Group, LTD. | Past | Accepting new patients |
Locations
1405 E 12th St
Mendota, IL 61342
Phone (815) 538-2031
1404 Washington St
Mendota, IL 61342
Phone (815) 538-1825
1050 E Norris Dr
Ste 3A
Ottawa, IL 61350
Phone (815) 431-5746
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
920 West St
Peru, IL 61354
Phone (815) 223-2143
925 West St
Peru, IL 61354
Phone (815) 223-3300
920 West St
Ste 221
Peru, IL 61354
Phone (815) 221-1304
530 Park Ave E
Ste 101
Princeton, IL 61356
Phone (815) 872-1221
600 E 1st St
Spring Valley, IL 61362
Phone (815) 664-1477
111 Spring St
Streator, IL 61364
Phone (815) 672-4587
2422 20th St SW
Jamestown, ND 58401
Phone (701) 252-1050
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085-000486 | IL | Yes |
Addresses
Primary practice location
1315 Memorial Dr
Mendota, IL 61342-1447
Mailing address
1315 Memorial Dr
Mendota, IL 61342-1447
Phone (815) 539-1422
Other names
- Pamela A Jones
Other providers in Mendota, IL
- Forest City Behavior LLC
- Alicia Foster
- Marissa Gatza
- Kristi Gonzales
- Goslin Drug Store Inc
- Heritage Manor - Mendota, LLC
- Heritage Manor Mendota, LLC
- Highland Park CVS, L.L.C.
- Ashlee Hoff
- Joshua Chase Humphrey
All providers in Mendota, IL · 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 Apr 13, 2009. 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.