NPIMap

Organization Active NPI

Sheldon Jordan, M.D., Inc.

  • Interventional Pain Medicine Physician
  • Santa Monica, CA
National Provider Identifier
1043241995
Registry record updated Apr 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
G38150 Issued in CA
Legal business name
SHELDON JORDAN, M.D., INC.
Practice address
2811 Wilshire Blvd
# 790
Santa Monica, CA 90403-4803
Phone
(310) 829-5968
Fax
(310) 453-3685
NPI assigned
Jul 6, 2006
Last updated
Apr 21, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2010

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

Authorized official

Name
Sheldon E Jordan, M.D.NPI 1316941305
Title
Incorporator
Phone
(310) 829-5968

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X G38150 CA Primary

Addresses

Primary practice location

2811 Wilshire Blvd
# 790
Santa Monica, CA 90403-4803

Mailing address

2811 Wilshire Blvd
# 790
Santa Monica, CA 90403-4803
Phone (310) 829-5968

Other names 1

  • SHELDON E. JORDAN, INC. A MEDICAL CORPORATION Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031105000832 CA Part B Supplier - Clinic/Group Practice 9436062536 Receives reassigned benefits from 31 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Orange, CA; Pasadena, CA; Playa Vista, CA; San Gabriel, CA; Santa Monica, CA; Glendale, CA; Sherman Oaks, CA; Thousand Oaks, CA…

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Foothill Anesthesia Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

30300 Agoura Rd
Ste B160
Agoura Hills, CA 91301
Phone (818) 889-1858

830 S Citrus Ave
Ste 101
Azusa, CA 91702
Phone (626) 543-1560

2211 W Magnolia Blvd
Ste 270
Burbank, CA 91506
Phone (800) 276-2021

1601 Pacific Coast Hwy
#150
Hermosa Beach, CA 90254
Phone (310) 402-2255

3500 N Sepulveda Blvd
Ste 130
Manhattan Beach, CA 90266
Phone (310) 648-2229

1301 20th St
Ste 300
Santa Monica, CA 90404
Phone (310) 829-7792

15477 Ventura Blvd
#103
Sherman Oaks, CA 91403
Phone (213) 408-9746

Practitioners & affiliated clinicians

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271808000000",
    "number": "1043241995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 WILSHIRE BLVD",
            "address_2": "# 790",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034803",
            "telephone_number": "310-829-5968",
            "fax_number": "310-453-3685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 WILSHIRE BLVD",
            "address_2": "# 790",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034803",
            "telephone_number": "310-829-5968",
            "fax_number": "310-453-3685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELDON JORDAN, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2010-04-21",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "SHELDON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "INCORPORATOR",
        "authorized_official_telephone_number": "310-829-5968",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "G38150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHELDON E. JORDAN, INC. A MEDICAL CORPORATION",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.