Individual provider Active NPI

Jared Lucas Roland, BHS,MPAS,PA-C

  • Physician Assistant
  • Lincoln, IL
National Provider Identifier
1336006535
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-011835 Issued in IL
Practice address
109 3Rd St
Lincoln, IL 62656-2604
Phone
(217) 735-2317
NPI assigned
Jan 8, 2026
Last updated
Feb 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

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 085-011835 IL Primary

Addresses

Primary practice location

109 3Rd St
Lincoln, IL 62656-2604

Mailing address

PO Box 19639
Springfield, IL 62794-9639
Phone (217) 545-8000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260224000917 IL Practitioner - Physician Assistant 4880175330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

109 3Rd St
Lincoln, IL 62656-2604
Phone (217) 545-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085-011835ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Trustees of Southern Illinois University CurrentSince Feb 12, 2026 Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince Feb 12, 2026 Accepting new patients

Locations

109 3rd St
Lincoln, IL 62656
Phone (217) 545-6523

520 N 4th St
Springfield, IL 62702
Phone (217) 757-8100

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 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": "1767830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1336006535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19639",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949639",
            "telephone_number": "217-545-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 3RD ST",
            "city": "LINCOLN",
            "state": "IL",
            "postal_code": "626562604",
            "telephone_number": "217-735-2317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLAND",
        "first_name": "JARED",
        "middle_name": "LUCAS",
        "credential": "BHS,MPAS,PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-01-08",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-011835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, IL

Sources for this page

Verify at the official NPI Registry.