Individual provider Active NPI

Mary Michele Hansen, PA-C, MPAS

  • Physician Assistant
  • Iowa City, IA
National Provider Identifier
1790846350
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001417 Issued in IA
Practice address
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone
(319) 356-2223
Fax
(319) 353-6754
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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 001417 IA Primary

Addresses

Primary practice location

200 Hawkins Dr
Iowa City, IA 52242-1009

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-2223

Other practice location 1

701 W Forevergreen Rd
North Liberty, IA 52317-9848
Phone (319) 356-2223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, SD2 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
I20070219000828 IA Practitioner - Physician Assistant 3870695034 Reassigns benefits to 1 organization
I20150331002525 SD Practitioner - Physician Assistant 3870695034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State University of IowaGroup PAC ID 7618884230, 1,886 clinicians

Practice addresses (Care Compare)

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-1616

701 W Forevergreen Rd
Univ of Ia Health Care Med Ctr N Liberty
North Liberty, IA 52317-9848
Phone (319) 485-0550

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.32 of 100Reported as group
Quality
75.87
Promoting interoperability
100
Improvement activities
40
Cost
68.53

Merit-based Incentive Payment System (MIPS)

Final score
84.78 of 100Reported as group
Quality
78.77
Promoting interoperability
100
Improvement activities
40
Cost
70.49

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State University of Iowa CurrentSince Jun 18, 2025 Accepting new patients
Sanford Medical Center CurrentSince Jan 10, 2015 Accepting new patients
Sanford Medical Center Physician Assistant CurrentSince Jan 10, 2015 Accepting new patients
State University of Iowa Past Accepting new patients

Locations

200 Hawkins Dr
Iowa City, IA 52242
Phone (319) 356-1616

200 Hawkins Dr
#H
Iowa City, IA 52242
Phone (319) 356-1616

701 W Forevergreen Rd
North Liberty, IA 52317
Phone (319) 356-2223

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

1305 W 18th St
Sioux Falls, SD 57105
Phone (605) 312-7300

1210 W 18th St
Ste G01
Sioux Falls, SD 57104
Phone (605) 328-1395

4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000

1210 W 18th St
Ste 100
Sioux Falls, SD 57104
Phone (605) 312-8500

20 S Plum St
Vermillion, SD 57069
Phone (605) 624-2611

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1790846350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-2223",
            "fax_number": "319-353-6754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-2223",
            "fax_number": "319-353-6754"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 W Forevergreen Rd",
            "address_purpose": "LOCATION",
            "city": "North Liberty",
            "state": "IA",
            "postal_code": "523179848",
            "country_code": "US",
            "telephone_number": "319-356-2223",
            "fax_number": "319-353-6754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "MARY",
        "middle_name": "MICHELE",
        "credential": "PA-C, MPAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "001417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.