Individual provider Active NPI

Joseph Albert Amavisca, MD

  • Family Medicine Physician
  • Hannibal, MO
National Provider Identifier
1316178189
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2025012600 Issued in MO
Practice address
100 Medical Dr
Hannibal, MO 63401-6877
Phone
(573) 221-5250
Fax
(573) 221-3706
NPI assigned
Jul 28, 2009
Last updated
Aug 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2025012600 MO Primary
Family Medicine Physician 207Q00000X MD156341 OR

Addresses

Primary practice location

100 Medical Dr
Hannibal, MO 63401-6877

Mailing address

1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-8400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jamavisca29542@blessing.medalliesdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, MO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120710000304 OR Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 9436314895 Reassigns benefits to 2 organizations
I20250514000997 MO Practitioner - Family Practice 9436314895 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blessing HospitalGroup PAC ID 3072422534, 414 clinicians

Practice addresses (Care Compare)

100 Medical Dr
Hannibal, MO 63401-6877

103 E Commercial St
Kahoka, MO 63445-1701
Phone (217) 223-8400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2025012600MOMDFamily Medicine Physician
MD156341ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blessing Hospital CurrentSince May 15, 2025 Accepting new patients
Legacy Meridian Park Hospital CurrentSince Aug 8, 2018 Accepting new patients
Blessing Hospital CurrentSince May 15, 2025 Accepting new patients
Legacy Meridian Park Hospital CurrentSince Aug 8, 2018 Accepting new patients
Legacy Clinics LLC Family Medicine CurrentSince Jul 13, 2020 Accepting new patients
Blessing Hospital Past Accepting new patients
Blessing Hospital Past Accepting new patients
Legacy Meridian Park Pediatric Rehab Past Accepting new patients

Locations

1005 Broadway St
Quincy, IL 62301

100 Medical Dr
Hannibal, MO 63401

101 Medical Dr
Hannibal, MO 63401

103 E Commercial St
Kahoka, MO 63445
Phone (660) 727-3377

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

19250 SW 65th Ave
Ste 250
Tualatin, OR 97062
Phone (503) 692-4820

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

19875 SW 65th Ave
Ste 100
Tualatin, OR 97062
Phone (503) 692-7785

1002 N Boones Ferry Rd
Woodburn, OR 97071
Phone (503) 981-9526

Interoperability endpoints

  • FHIR API: https://fhir.blessinghospital.com/R4/open-Prod

Organizations & group practices 8

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 4

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": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1316178189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012834",
            "telephone_number": "217-223-8400",
            "fax_number": "217-277-3960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016877",
            "telephone_number": "573-221-5250",
            "fax_number": "573-221-3706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMAVISCA",
        "first_name": "JOSEPH",
        "middle_name": "ALBERT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-28",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2025012600",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD156341",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jamavisca29542@blessing.medalliesdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "100 Medical Dr",
            "city": "Hannibal",
            "state": "MO",
            "country_code": "US",
            "postal_code": "634016877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hannibal, MO

Sources for this page

Verify at the official NPI Registry.