Individual provider Active NPI

Ian Hart, PA-C

  • Physician Assistant
  • Silvis, IL
National Provider Identifier
1295254175
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085006344 Issued in IL
Practice address
801 Illini Dr
Silvis, IL 61282-1804
Phone
(309) 281-4074
NPI assigned
Sep 12, 2017
Last updated
Sep 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA201723 OR
Physician Assistant 363A00000X 085006344 IL Primary

Addresses

Primary practice location

801 Illini Dr
Silvis, IL 61282-1804

Mailing address

1515 Village Dr
Cottage Grove, OR 97424-9700
Phone (541) 767-5222

Other practice location 1

1515 Village Dr
Cottage Grove, OR 97424-9700
Phone (541) 767-5222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20201028000431 OR Practitioner - Physician Assistant 8426318908 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth Medical Group Cottage Grove Current Accepting new patients

Locations

1515 Village Dr
Cottage Grove, OR 97424
Phone (541) 767-5200

Interoperability endpoints

  • Direct secure messaging: ihart451889@direct.peacehealth.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1505174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1295254175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 VILLAGE DR",
            "city": "COTTAGE GROVE",
            "state": "OR",
            "postal_code": "974249700",
            "telephone_number": "541-767-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 ILLINI DR",
            "city": "SILVIS",
            "state": "IL",
            "postal_code": "612821804",
            "telephone_number": "309-281-4074"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 Village Dr",
            "address_purpose": "LOCATION",
            "city": "Cottage Grove",
            "state": "OR",
            "postal_code": "974249700",
            "country_code": "US",
            "telephone_number": "541-767-5222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HART",
        "first_name": "IAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-12",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA201723",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085006344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silvis, IL

Sources for this page

Verify at the official NPI Registry.