NPIMap

Individual provider Active NPI

Amy Hamilton, PA-C

  • Physician Assistant
  • Saint Paul, MN
National Provider Identifier
1750353785
Registry record updated Apr 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10969 Issued in MN
Practice address
640 Jackson St
Saint Paul, MN 55101-2502
Phone
(651) 254-3456
NPI assigned
Feb 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2017

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 PA9102727 FL
Physician Assistant 363A00000X 10969 MN Primary

Addresses

Primary practice location

640 Jackson St
Saint Paul, MN 55101-2502

Mailing address

PO Box 1309
Ms 21110Q
Minneapolis, MN 55440-1309
Phone (952) 883-7172

Other identifiers 5

IdentifierTypeStateIssuer
2918811-00MedicaidFL
ENROLLEDMedicaidMN
U2774YOtherFLMEDICARE SOUTH GULF
U2774ZOtherFLMEDICARE SOUTHWEST
P01045289OtherMNRAILROAD MEDICARE

Other names 1

  • Amy Hamilton Former name

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
I20111019000898 MN Practitioner - Physician Assistant 1153392238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regions HospitalGroup PAC ID 3173436755, 215 clinicians

Practice addresses (Care Compare)

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 221-2164

Hospital & facility affiliations

  • Regions Hospital Hospital, Saint Paul, MN, CCN 240106

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9102727FLMDPhysician Assistant
10969MNMDPhysician Assistant
1591MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Regions Hospital CurrentSince Apr 1, 2013 Accepting new patients
South Gulf Coast Emergency Physicians PA Past Accepting new patients
Regions Hospital Past Accepting new patients
Florida Em-I Medical Services PA Past Accepting new patients

Locations

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

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 8

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": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491523200000",
    "number": "1750353785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1309",
            "address_2": "MS 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554401309",
            "telephone_number": "952-883-7172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "AMY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-03",
        "last_updated": "2017-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9102727",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2918811-00",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE SOUTH GULF",
            "identifier": "U2774Y",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE SOUTHWEST",
            "identifier": "U2774Z",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01045289",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "HAMILTON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.