Individual provider Active NPI

Hannah Elizabeth Palmer, PA

  • Physician Assistant
  • Carbondale, IL
National Provider Identifier
1548972201
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085009297 Issued in IL
Practice address
305 W Jackson St Ste 301
Carbondale, IL 62901-1474
Phone
(618) 529-0520
Fax
(618) 529-0519
NPI assigned
Dec 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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 085009297 IL Primary

Addresses

Primary practice location

305 W Jackson St Ste 301
Carbondale, IL 62901-1474

Mailing address

PO Box 3988
Carbondale, IL 62902-3988

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hpalmer40578@sih.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20230126001868 IL Practitioner - Physician Assistant 6709257900 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Southern Illinois University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinity Medical Staffing LLCGroup PAC ID 1759712698, 35 clinicians

Practice addresses (Care Compare)

100 Dr Warren Tuttle Dr
Harrisburg, IL 62946-2718
Phone (618) 253-7671

2601 W Main St
Carbondale, IL 62901-1031
Phone (618) 549-5361

405 W Jackson St
Carbondale, IL 62901-1462
Phone (618) 549-0721

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82 of 100Reported as group
Quality
55.9
Promoting interoperability
100
Improvement activities
40
Cost
72.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085009297ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Illinois Medical Services, NFP CurrentSince Feb 6, 2023 Accepting new patients
Memorial Management Inc PastSince Jul 21, 2024 Accepting new patients

Locations

409 W Oak St
Ste 202
Carbondale, IL 62901
Phone (618) 295-0555

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

305 W Jackson St
Ste 301
Carbondale, IL 62901
Phone (618) 529-0520

100 Dr Warren Tuttle Dr
Harrisburg, IL 62946
Phone (618) 252-4956

Interoperability endpoints

  • Direct secure messaging: hpalmer40578@sih.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1670976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1548972201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3988",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W JACKSON ST STE 301",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011474",
            "telephone_number": "618-529-0520",
            "fax_number": "618-529-0519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "HANNAH",
        "middle_name": "ELIZABETH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-14",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085009297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hpalmer40578@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "305 W Jackson St Ste 301",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.