Active NPI
Robert Paul Jordan, D.P.M.
- Foot Surgery Podiatrist
- E Northport, NY
National Provider Identifier
1033193362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot Surgery Podiatrist
- License
- NY002856
- Practice address
- 1023 Pulaski Rd
E Northport, NY 11731-1931 - Phone
- (631) 754-3261
- Fax
- (631) 754-3767
- NPI assigned
- Nov 30, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot Surgery Podiatrist | 213ES0131X | NY002856 | NY | Primary |
Addresses
Primary practice location
1023 Pulaski Rd
E Northport, NY 11731-1931
Mailing address
19 Fox Hollow Ridings Rd
Northport, NY 11768-2244
Phone (631) 754-3261
Other names 1
- Dr. R. Paul Jordan
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NY002856 | NY | MD | Foot Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1033193362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 FOX HOLLOW RIDINGS RD",
"city": "NORTHPORT",
"state": "NY",
"postal_code": "117682244",
"telephone_number": "631-754-3261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1023 PULASKI RD",
"city": "E NORTHPORT",
"state": "NY",
"postal_code": "117311931",
"telephone_number": "631-754-3261",
"fax_number": "631-754-3767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "ROBERT",
"middle_name": "PAUL",
"credential": "D.P.M.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-30",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0131X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot Surgery",
"state": "NY",
"license": "NY002856",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "R.",
"last_name": "JORDAN",
"middle_name": "PAUL",
"prefix": "DR.",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in E Northport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.