Individual provider Active NPI

Anna Marie Hernstrom, PA-S

  • Physician Assistant
  • Bettendorf, IA
National Provider Identifier
1861175093
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
131770 Issued in IA
Practice address
1351 Kimberly Rd Ste 100
Bettendorf, IA 52722-4193
Phone
(563) 355-7733
Fax
(563) 355-9077
NPI assigned
Aug 14, 2023
Last updated
Jul 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 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 131770 IA Primary

Addresses

Primary practice location

1351 Kimberly Rd Ste 100
Bettendorf, IA 52722-4193

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20250724001499 IA Practitioner - Physician Assistant 9830605922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
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)

1351 Kimberly Rd
Suite 100
Bettendorf, IA 52722-4193
Phone (563) 355-7733

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

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State University of Iowa CurrentSince Jul 16, 2025 Accepting new patients
State University of Iowa Past Accepting new patients

Locations

1351 Kimberly Rd
Ste 100
Bettendorf, IA 52722
Phone (563) 355-7733

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

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

Organizations & group practices 2

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 4

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": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1861175093",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 KIMBERLY RD STE 100",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527224193",
            "telephone_number": "563-355-7733",
            "fax_number": "563-355-9077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNSTROM",
        "first_name": "ANNA",
        "middle_name": "MARIE",
        "credential": "PA-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "131770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bettendorf, IA

Sources for this page

Verify at the official NPI Registry.