JENNIFER GUNDERSON
NPI 1366175986
Physician Assistant - Medical in Beloit, WI

Active since July 01, 2022PECOS EnrolledAccepts Medicare Assignment
1969 W HART RD, BELOIT, WI 53511(608) 364-5011 Get Directions Write a Review

NPPES record last updated: January 30, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Jennifer Gunderson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JENNIFER GUNDERSON (NPI 1366175986) is an individual medical provider in Beloit, Wisconsin, licensed in Wisconsin (7374-23) and active in the NPI registry since July 2022. She is enrolled in Medicare PECOS, is affiliated with Fort Memorial Hospital, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1366175986
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameJENNIFER GUNDERSON
Location Address1969 W HART RDBeloit, WI 53511-2230
Mailing AddressPo Box 431Janesville, WI 53547-0431 · (405) 696-7932
Sole ProprietorYes
Medical School CMSOtherGraduated 2023
Enumeration DateJuly 1, 2022
Last NPPES UpdateJanuary 30, 2024
NPPES CertifiedJanuary 30, 2024
NPI 1366175986 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License Licensed in WI · 7374-23
1969 W HART RD, Beloit, WI 53511

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Jennifer Gunderson is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8729447685
PECOS Enrollment IDI20230710003490
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Fort Memorial Hospital

Acute Care Hospitals · Fort Atkinson, WI
OwnershipVoluntary non-profit - Private
CMS Certification Number520071
Location611 Sherman Ave EFort Atkinson, WI 53538 · Jefferson County
Emergency services Birthing friendly

Stoughton Hospital

Critical Access Hospitals · Stoughton, WI
OwnershipVoluntary non-profit - Private
CMS Certification Number521343
Location900 Ridge StStoughton, WI 53589 · Dane County
Emergency services

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Medicine & Rehabilitation (Pain Medicine)
1969 W HART RD
BELOIT, WI 53511
Anesthesiology
1969 W HART RD
BELOIT, WI 53511
Anesthesiology
1969 W HART RD, BELOIT MEMORIAL HOSPITAL
BELOIT, WI 53511
Anesthesiology
1969 W HART RD
BELOIT, WI 53511
Radiology (Diagnostic Radiology)
1969 W HART RD
BELOIT, WI 53511
Internal Medicine
1969 W HART RD
BELOIT, WI 53511
Emergency Medicine
1969 W HART RD
BELOIT, WI 53511
Emergency Medicine
1969 W HART RD
BELOIT, WI 53511

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1366175986, enumerated as an "individual" on July 01, 2022.

The provider is located at 1969 W HART RD BELOIT, WI 53511 and the phone number is (608) 364-5011.

Physician Assistant with taxonomy code 363AM0700X and a focus in Medical.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield and Group Health. Please consult your insurance carrier or call the provider to verify.

Jennifer Gunderson is affiliated with: FORT MEMORIAL HOSPITAL and STOUGHTON HOSPITAL.