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NPI Code Detail

MEDICARE: JARED LUCAS ROLAND BHS,MPAS,PA-C

MEDICARE: JARED LUCAS ROLAND BHS,MPAS,PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant085-011835IL

General Provider Information

NPI Number : 1336006535
Entity Type Code : Individual
Provider Name (Legal Business Name) : JARED LUCAS ROLAND BHS,MPAS,PA-C
Provider Business Mailing Address
First Line : PO BOX 19639
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62794-9639
Country : US
Telephone Number : 217-545-8000
Fax Number :
Provider Business Practice Location Address
First Line : 109 3RD ST
Second Line :
City : LINCOLN
State : IL
Zip : 62656-2604
Country : US
Telephone Number : 217-735-2317
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2026
Last Update Date : 02/12/2026

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