Individual provider Active NPI

Jasmine Rachelle Hammerstad

  • Physician Assistant
  • Evanston, IL
National Provider Identifier
1245977461
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1881 Oak Ave # Aptph02W
Evanston, IL 60201-3980
Phone
(541) 231-9307
NPI assigned
May 18, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2022

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 Primary

Addresses

Primary practice location

1881 Oak Ave # Aptph02W
Evanston, IL 60201-3980

Mailing address

1881 Oak Ave # Aptph02W
Evanston, IL 60201-3980
Phone (541) 231-9307

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221201002379 IL Practitioner - Physician Assistant 4587032131 Reassigns benefits to 2 organizations
I20231114000681 NY Practitioner - Physician Assistant 4587032131 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Oct 13, 2023 Accepting new patients
The University of Chicago Medical Center CurrentSince Aug 6, 2022 Accepting new patients
Montefiore Medical Center CurrentSince Oct 13, 2023 Accepting new patients
The University of Chicago Medical Center CurrentSince Aug 6, 2022 Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

111 E 210th St
Bronx, NY 10467

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1652832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1245977461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1881 OAK AVE # APTPH02W",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013980",
            "telephone_number": "541-231-9307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 OAK AVE # APTPH02W",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013980",
            "telephone_number": "541-231-9307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMERSTAD",
        "first_name": "JASMINE",
        "middle_name": "RACHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-18",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.