Jacob Matthew Vondebur, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085011450 Issued in IL

Practice address

2303 Huntington Rd
Springfield, IL 62703-5009

Phone

(217) 303-4991

NPI assigned

Jun 5, 2025

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

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.

• Rockford Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Rockford, IL
  • NPI 1639876634
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1749081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1235023045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2303 HUNTINGTON RD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627035009",
            "telephone_number": "217-303-4991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2303 HUNTINGTON RD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627035009",
            "telephone_number": "217-303-4991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONDEBUR",
        "first_name": "JACOB",
        "middle_name": "MATTHEW",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-05",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085011450",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sue Jane Volarich, D.O.
• Kent C Volker, RPH, MS
• Meredith Volle
• Madison Volpert, OTD
• Casey Matthew Vondebur, PHARMD
• Jonathan Vonk, MD
• Vono Pharmacy & Convenient Center, Inc.
• Joseph Connor Vorreyer, MD
• Matthew Dale Vortman, P.T.
• Aaron Michael Voshage, MD

• Physician Assistant in Springfield, IL
• Providers in Springfield, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.