Active NPI
Jennifer Gunderson
- Medical Physician Assistant
- Beloit, WI
National Provider Identifier
1366175986
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 7374-23
- Practice address
- 1969 W Hart Rd
Beloit, WI 53511-2230 - Phone
- (608) 364-5011
- NPI assigned
- Jul 1, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Medical Physician Assistant | 363AM0700X | 7374-23 | WI | Primary |
Addresses
Primary practice location
1969 W Hart Rd
Beloit, WI 53511-2230
Mailing address
PO Box 431
Janesville, WI 53547-0431
Phone (405) 696-7932
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- University of Wisconsin School of Medicine, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4 Burdick St
Edgerton, WI 53534-1729
Phone (608) 884-3441
5605 E Rockton Rd
Roscoe, IL 61073-7601
Phone (815) 525-4100
5614 US Hwy 51
McFarland, WI 53558-8708
Phone (608) 838-8242
611 Sherman Ave E
Fort Atkinson, WI 53538-1960
Phone (920) 568-5475
900 Ridge St
Stoughton, WI 53589-1864
Phone (608) 873-6611
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.73 of 100
- Quality
- 87.42
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 65.02
Merit-based Incentive Payment System (MIPS)
- Final score
- 69.34 of 100
- Quality
- 87.81
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 10
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7374-23 | WI | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stoughton Hospital Association | Current | Accepting new patients | |
| Edgerton Hospital and Health Services | Current | Accepting new patients | |
| Edgerton Hospital and Health Services Inc. | Current | Accepting new patients | |
| Stoughton Hospital Association | Current | Accepting new patients | |
| Edgerton Hospital and Health Services, Inc | Current | Accepting new patients | |
| Stoughton Hospital Association | Past | Accepting new patients |
Locations
11101 N Sherman Rd
Edgerton, WI 53534
Phone (608) 884-1695
831 Arthur Dr
Milton, WI 53563
Phone (608) 868-3526
900 Ridge St
Stoughton, WI 53589
Phone (608) 231-3410
Organizations & group practices 8
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.
-
- Critical Access Hospital
- Edgerton, WI
- NPI 1154350049
-
- Critical Access Hospital
- Stoughton, WI
- NPI 1679558647
-
- Emergency Medicine Physician
- Beloit, WI
- NPI 1568538189
IL
-
- Emergency Medicine Physician
- Fort Atkinson, WI
- NPI 1295552065
-
- Urgent Care Clinic/Center
- Edgerton, WI
- NPI 1538845805
-
- Urgent Care Clinic/Center
- Whitewater, WI
- NPI 1982496295
-
- Urgent Care Clinic/Center
- McFarland, WI
- NPI 1477146082
-
- Urgent Care Clinic/Center
- Cottage Grove, WI
- NPI 1811733066
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fort Atkinson, WI
- NPI 1811916281
-
- Critical Access Hospital
- Stoughton, WI
- NPI 1679558647
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706572800000",
"number": "1366175986",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 431",
"city": "JANESVILLE",
"state": "WI",
"postal_code": "535470431",
"telephone_number": "405-696-7932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1969 W HART RD",
"city": "BELOIT",
"state": "WI",
"postal_code": "535112230",
"telephone_number": "608-364-5011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUNDERSON",
"first_name": "JENNIFER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-01",
"last_updated": "2024-01-30",
"certification_date": "2024-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WI",
"license": "7374-23",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beloit, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; 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.