NPIMap

Individual provider Active NPI

Samantha Ann Hammer, PA

  • Physician Assistant
  • Champlin, MN
National Provider Identifier
1508214511
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12169 Issued in MN
Practice address
12142 Business Park Blvd N
Champlin, MN 55316-4525
Phone
(952) 977-0500
NPI assigned
May 31, 2016
Last updated
Jul 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 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 12169 MN Primary
Medical Physician Assistant 363AM0700X 2531 MN

Addresses

Primary practice location

12142 Business Park Blvd N
Champlin, MN 55316-4525

Mailing address

8170 33Rd Ave S # Ms 21110Q
Bloomington, MN 55425-4516
Phone (952) 977-0500

Other practice location 1

300 S Bruce St
Marshall, MN 56258-1934
Phone (507) 537-9007 ext. 4

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160920000516 MN Practitioner - Physician Assistant 2264729201 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rural Health Care IncGroup PAC ID 3476447541, 156 clinicians
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

1216 Ryans Rd
Suite 3
Worthington, MN 56187-1781
Phone (507) 372-6522

1521 Carlson St
Suite 100
Marshall, MN 56258-2626
Phone (507) 473-4800

3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2531MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic CurrentSince Jul 21, 2025 Accepting new patients
Avera Tyler CurrentSince Jun 23, 2018 Accepting new patients
Rural Health Care, Inc CurrentSince Jan 1, 2022 Accepting new patients
Park Nicollet Methodist Hospital CurrentSince Jul 21, 2025 Accepting new patients
Avera Marshall CurrentSince Sep 1, 2016 Accepting new patients
Avera Marshall CurrentSince Sep 1, 2016 Accepting new patients

Locations

12142 Business Park Blvd N
Champlin, MN 55316
Phone (952) 977-0500

300 S Bruce St
Marshall, MN 56258
Phone (507) 532-9631

300 S Bruce St
Ste 100
Marshall, MN 56258

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

1325 S Cliff Ave
Sioux Falls, SD 57105
Phone (605) 322-5000

Interoperability endpoints

  • Direct secure messaging: samantha.hammer@avera.sdhealthlink.net

Organizations & group practices 10

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 7

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": "1464652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1508214511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "952-977-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12142 BUSINESS PARK BLVD N",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "553164525",
            "telephone_number": "952-977-0500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 S Bruce St",
            "address_purpose": "LOCATION",
            "city": "Marshall",
            "state": "MN",
            "postal_code": "562581934",
            "country_code": "US",
            "telephone_number": "507-537-9007 x4",
            "fax_number": "507-537-2720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMMER",
        "first_name": "SAMANTHA",
        "middle_name": "ANN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-31",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12169",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "2531",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champlin, MN

Sources for this page

Verify at the official NPI Registry.