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Individual provider Active NPI

Pamela A Hansen, PA-C

  • Physician Assistant
  • Mendota, IL
National Provider Identifier
1245306166
Registry record updated Apr 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-000486 Issued in IL
Practice address
1315 Memorial Dr
Mendota, IL 61342-1447
Phone
(815) 539-1422
Fax
(815) 539-1436
NPI assigned
Nov 24, 2006
Last updated
Apr 13, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2009

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 085-000486 IL Primary

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 1

  • Pamela A Jones Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, ND2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040511000534 IL Practitioner - Physician Assistant 3274522693 Reassigns benefits to 1 organization
I20230703001889 ND Practitioner - Physician Assistant 3274522693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
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 GroupGroup PAC ID 3678889789, 2,123 clinicians

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

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085-000486ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Charity Association CurrentSince Jul 10, 2023 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Lutheran Charity Association CurrentSince Jul 10, 2023 Accepting new patients
Mendota Community Hospital Past Accepting new patients
Cardinal Medical Group, LTD. Past Accepting new patients

Locations

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

2422 20th St SW
Jamestown, ND 58401
Phone (701) 252-1050

Organizations & group practices 7

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 2

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": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239580800000",
    "number": "1245306166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 MEMORIAL DR",
            "city": "MENDOTA",
            "state": "IL",
            "postal_code": "613421447",
            "telephone_number": "815-539-1422",
            "fax_number": "815-539-1436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 MEMORIAL DR",
            "city": "MENDOTA",
            "state": "IL",
            "postal_code": "613421447",
            "telephone_number": "815-539-1422",
            "fax_number": "815-539-1436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "PAMELA",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-24",
        "last_updated": "2009-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-000486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "JONES",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mendota, IL

Sources for this page

Verify at the official NPI Registry.