Individual provider Active NPI

Jennifer R Sunderland, PA-C

  • Physician Assistant
  • Decatur, IL
National Provider Identifier
1659475655
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085003210 Issued in IL
Practice address
250 W Kenwood Ave
Decatur, IL 62526-4371
Phone
(217) 528-7541
NPI assigned
Sep 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085003210 IL
Physician Assistant 363A00000X 085003210 IL Primary

Addresses

Primary practice location

250 W Kenwood Ave
Decatur, IL 62526-4371

Mailing address

PO Box 19248
Springfield, IL 62794-9248
Phone (217) 528-7541

Other identifiers 3

IdentifierTypeStateIssuer
202735OtherILMEDICARE PTAN LOCALITY 15
604530OtherILMEDICARE PTAN LOCALITY 16
215827OtherILMEDICARE PTAN LOCALITY 99

Other names 1

  • Jennifer R Ware Professional name

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
I20080603000024 IL Practitioner - Physician Assistant 5395700173 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Springfield Clinic, LLPGroup PAC ID 0547166076, 678 clinicians

Practice addresses (Care Compare)

100 Stahlhut Dr
Lincoln, IL 62656-5059
Phone (217) 735-9555

1025 S 6TH St
Springfield, IL 62703-2403
Phone (217) 528-7541

2200 Wabash Ave
Springfield, IL 62704-5352
Phone (217) 787-0727

250 W Kenwood Ave
Decatur, IL 62526-4371
Phone (217) 528-7541

400 Saint Johns Dr
Sherman, IL 62684-9779
Phone (217) 525-4150

600 N Main St
Taylorville, IL 62568-1668
Phone (217) 824-8191

775 Engineering Ave
Springfield, IL 62703-5909
Phone (217) 522-4300

800 N 1St St
Springfield, IL 62702-3719
Phone (217) 528-7541

801 W Temple Ave
Effingham, IL 62401-2168
Phone (217) 528-7541

Hospital & facility affiliations

  • Memorial Medical Center Hospital, Springfield, IL, CCN 140148
  • Decatur Memorial Hospital Hospital, Decatur, IL, CCN 140135
  • Abraham Lincoln Memorial Hospital Hospital, Lincoln, IL, CCN 141322
  • Taylorville Memorial Hospital Hospital, Taylorville, IL, CCN 141339
  • St Marys Hospital Hospital, Decatur, IL, CCN 140166

Merit-based Incentive Payment System (MIPS)

Final score
88.83 of 100Reported as apm
Quality
75.65
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as apm
Quality
72.1
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085003210ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
HSHS Medical Group Inc CurrentSince Jan 5, 2014 Accepting new patients
HSHS Medical Group Inc CurrentSince Jan 5, 2014 Accepting new patients
Springfield Clinic, LLP CurrentSince Jan 17, 2021 Accepting new patients
Midwest Orthopaedics at Rush, LLC Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Springfield Clinic, LLP Past Accepting new patients
Neurosurgery and Endovascular Associates SC. Past Accepting new patients

Locations

1900 E Lake Shore Dr
Ste 330
Decatur, IL 62521
Phone (217) 423-2889

1750 E Lake Shore Dr
Decatur, IL 62521
Phone (217) 425-2732

250 W Kenwood Ave
Decatur, IL 62526
Phone (217) 872-3800

1750 E Lake Shore Dr
Ste 110
Decatur, IL 62521
Phone (217) 464-1200

100 Stahlhut Dr
Lincoln, IL 62656
Phone (217) 735-9555

101 E 9th St
Pana, IL 62557
Phone (217) 562-2131

775 Engineering Ave
Springfield, IL 62703
Phone (217) 522-4300

600 N Main St
Taylorville, IL 62568
Phone (217) 287-8855

Interoperability endpoints

  • Direct secure messaging: jennifer.sunderland.1@28977.direct.athenahealth.com

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.

Hospital & facility affiliations 5

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": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1659475655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19248",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949248",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 W KENWOOD AVE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264371",
            "telephone_number": "217-528-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDERLAND",
        "first_name": "JENNIFER",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-11",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085003210",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085003210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN LOCALITY 15",
            "identifier": "202735",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN LOCALITY 16",
            "identifier": "604530",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN LOCALITY 99",
            "identifier": "215827",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "WARE",
            "middle_name": "R",
            "credential": "PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.