Jennifer Ann Sanders, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085008546 Issued in IL

Practice address

409 W Oak St
Carbondale, IL 62901-1464

Phone

(618) 529-4455

NPI assigned

May 16, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Electronic endpoints 4

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

Merit-based Incentive Payment System (MIPS)

Final score

82 of 100Reported as group

Quality

55.9

Promoting interoperability

100

Improvement activities

40

Cost

72.01

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Southern Illinois Medical Services, NFP

  • Internal Medicine Physician
  • Carbondale, IL
  • NPI 1770656837
  Medicare reassignment NPD
• Memorial Hospital

  • Critical Access Hospital
  • Chester, IL
  • NPI 1851390132
  Medicare reassignment

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

{
    "created_epoch": "1589587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1346862984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3988",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023988",
            "telephone_number": "618-457-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 W OAK ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011464",
            "telephone_number": "618-529-4455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "217 S Park Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "Herrin",
            "state": "IL",
            "postal_code": "629483611",
            "country_code": "US",
            "telephone_number": "618-529-4455",
            "fax_number": "618-351-1287",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 S Hospital Dr Fl 2",
            "address_purpose": "LOCATION",
            "city": "Murphysboro",
            "state": "IL",
            "postal_code": "629663333",
            "country_code": "US",
            "telephone_number": "618-529-4455",
            "fax_number": "618-351-1287",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3905 W Ernestine Dr",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "IL",
            "postal_code": "629595800",
            "country_code": "US",
            "telephone_number": "618-529-4455",
            "fax_number": "618-351-1287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-16",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085.008546",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085008546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsanders8003@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "2 S Hospital Dr Fl 2",
            "city": "Murphysboro",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629663333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsanders8003@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "409 W Oak St",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011464",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsanders8003@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "217 S Park Ave Ste 2",
            "city": "Herrin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629483611",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsanders8003@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "3905 W Ernestine Dr",
            "city": "Marion",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629595800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ayesha Saeed, MD
• Ashmeet Singh Sahni, MD
• Fatoumata Saidou Hangadoumbo, PHD, MPH, CHES
• Anad K Salem, MD
• Sruthi Samala, DO
• Mitchell Wayne Sanders
• Simrandeep Sandhu
• Parviz B. Sanjabi, MD
• Carmelo Antonio Saraceno, M.D.
• Sarah Hasek, MD, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.