Individual provider Active NPI

Alyssa Lakin, PA C

  • Family Medicine Physician
  • Maquoketa, IA
National Provider Identifier
1629415922
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
002423 Issued in IA
Practice address
206 N Arcade
Maquoketa, IA 52060-2022
Phone
(563) 652-6711
Fax
(563) 652-6715
NPI assigned
May 28, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 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
Family Medicine Physician 207Q00000X 002423 IA Primary

Addresses

Primary practice location

206 N Arcade
Maquoketa, IA 52060-2022

Mailing address

4909 N Glen Park Place Rd
Peoria, IL 61614-4676
Phone (563) 652-6711

Other practice location 1

2300 53rd Ave Ste 100
Bettendorf, IA 52722-7565
Phone (563) 322-0971

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, IL2 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
I20140123000448 IA Practitioner - Physician Assistant 0941438824 Reassigns benefits to 3 organizations
I20220120001201 IL Practitioner - Physician Assistant 0941438824 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Soderstrom Dermatology Center S CGroup PAC ID 2062432651, 31 clinicians
Genesis Health SystemGroup PAC ID 7214841436, 217 clinicians

Practice addresses (Care Compare)

1302 7TH St
Suite 202
Moline, IL 61265-2900
Phone (309) 277-0772

1520 W 53Rd St
Mercyone Genesis Northwest Convenie
Davenport, IA 52806-2459
Phone (563) 421-3800

1800 E 54TH St
Suite B
Davenport, IA 52807-2852
Phone (563) 344-7546

2300 A Park Ave
Muscatine, IA 52761-5444
Phone (563) 263-2113

301 N 4TH Ave
Mercyone Genesis Eldridge
Eldridge, IA 52748-1113
Phone (563) 421-9880

4321 53Rd Ave
Bettendorf, IA 52722-1269
Phone (563) 421-5300

4909 N Glen Park Place Rd
Peoria, IL 61614-4676
Phone (309) 674-7546

619 5TH St
Durant, IA 52747-7737
Phone (563) 785-4487

Hospital & facility affiliations

  • Genesis HLTH System Dba Genesis MDL Ctr-Illini Hospital, Silvis, IL, CCN 140275
  • Genesis Medical Center-Davenport Hospital, Davenport, IA, CCN 160033

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score
67.53 of 100Reported as apm
Quality
92.42
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002423IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Health System CurrentSince Oct 7, 2024 Accepting new patients
Soderstrom Dermatology Center S C CurrentSince Aug 2, 2021 Accepting new patients
Genesis Health System CurrentSince Oct 7, 2024 Accepting new patients
Genesis Health System Family Medicine CurrentSince Oct 17, 2024 Accepting new patients
Ora Orthopedics, PC Past Accepting new patients

Locations

2300 53rd Ave
Ste 100
Bettendorf, IA 52722
Phone (563) 459-4005

2027 S 21st St
Clinton, IA 52732
Phone (563) 242-3571

1351 W Central Park Ave
Ste 4100
Davenport, IA 52804
Phone (563) 355-9191

210 W 53rd St
Davenport, IA 52806
Phone (563) 386-3436

1414 W Lombard St
Davenport, IA 52804
Phone (563) 326-6431

1800 E 54th St
Ste B
Davenport, IA 52807
Phone (563) 242-3571

1950 E 54th St
Davenport, IA 52807
Phone (563) 344-7546

619 5th St
Durant, IA 52747
Phone (563) 785-4487

2300A Park Ave
Muscatine, IA 52761
Phone (563) 263-2113

202 Picard St
Alpha, IL 61413
Phone (309) 629-4601

306 46th Ave
East Moline, IL 61244
Phone (309) 796-2329

60 S Soangetaha Rd
Galesburg, IL 61401
Phone (309) 344-5777

1302 7th St
Ste 202
Moline, IL 61265
Phone (309) 277-0772

4909 N Glen Park Place Rd
Peoria, IL 61614
Phone (309) 674-7546

Interoperability endpoints

  • Direct secure messaging: alakin@directaddress.net

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1369699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1629415922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4909 N GLEN PARK PLACE RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144676",
            "telephone_number": "563-652-6711",
            "fax_number": "563-652-6715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 N ARCADE",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "520602022",
            "telephone_number": "563-652-6711",
            "fax_number": "563-652-6715"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 53rd Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Bettendorf",
            "state": "IA",
            "postal_code": "527227565",
            "country_code": "US",
            "telephone_number": "563-322-0971",
            "fax_number": "563-324-0615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAKIN",
        "first_name": "ALYSSA",
        "name_prefix": "Ms.",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-28",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "002423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maquoketa, IA

Sources for this page

Verify at the official NPI Registry.