Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Autumn Marie Hanna, PA

Individual provider Physician Assistant · NPI 1003677964

Autumn Marie Hanna, PA is a Physician Assistant in South Bend, Indiana. Qualified in 2023, 3 years ago. Practices with The South Bend Clinic LLC, a 170-clinician group, accepts Medicare assignment and offers telehealth.

Years since qualifying
3
In the registry since
2024
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

211 N Eddy St
South Bend, IN 46617-2808
Phone: (574) 234-8161
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1003677964
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedJanuary 18, 2024
Last updated in NPPESAugust 19, 2025
Certification dateAugust 19, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice The South Bend Clinic Llc — 170 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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