Individual provider Active NPI

Jordan S Orange, M.D.

  • Pediatric Allergy/Immunology Physician
  • New York, NY
National Provider Identifier
1033123591
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Allergy/Immunology PhysicianTaxonomy code 2080P0201X
License
294122 Issued in NY
Practice address
630 W 168TH St # ST1
New York, NY 10032-3725
Phone
(212) 305-2934
NPI assigned
Jul 28, 2006
Last updated
Feb 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Allergy/Immunology Physician 2080P0201X 294122 NY Primary

Addresses

Primary practice location

630 W 168TH St # ST1
New York, NY 10032-3725

Mailing address

630 W 168TH St # ST1
New York, NY 10032-3725
Phone (212) 305-2934

Other identifiers 2

IdentifierTypeStateIssuer
0015806MedicaidNJ
100820449MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180725001211 NY Practitioner - Pediatric Medicine 3173703568 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York Pediatrics CurrentSince Jun 11, 2018 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jun 11, 2018 Accepting new patients
Trustees of Columbia University in the City of New York Pediatrics CurrentSince Jun 11, 2018 Accepting new patients
Childrens Health Care Associates of New Jersey PC Pediatrics Past Accepting new patients

Locations

630 W 168th St
New York, NY 10032
Phone (212) 305-1948

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

630 W 168th St
#1
New York, NY 10032
Phone (212) 305-2934

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

622 W 168th St
Ph 5505
New York, NY 10032
Phone (212) 305-6494

2026 Richmond Rd
Staten Island, NY 10306
Phone (212) 305-2300

Interoperability endpoints

  • Direct secure messaging: jso9005@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1033123591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 W 168TH ST # ST1",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323725",
            "telephone_number": "212-305-2934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 W 168TH ST # ST1",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323725",
            "telephone_number": "212-305-2934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORANGE",
        "first_name": "JORDAN",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "NY",
            "license": "294122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015806",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100820449",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.