Individual provider Active NPI

Jordan Charles Templeton

  • Medical Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1053911156
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA061977 Issued in PA
Practice address
3400 Spruce St
Philadelphia, PA 19104-4274
Phone
(215) 316-5151
NPI assigned
Oct 28, 2020
Last updated
Oct 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA061977 PA Primary

Addresses

Primary practice location

3400 Spruce St
Philadelphia, PA 19104-4274

Mailing address

2039 Saint Albans St
Philadelphia, PA 19146-1334
Phone (610) 737-6228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220112000642 PA Practitioner - Physician Assistant 8628481751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA061977PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group Multi-Specialty CurrentSince Jan 10, 2022 Accepting new patients
University of Penn-Medical Group Multi-Specialty CurrentSince Jan 10, 2022 Accepting new patients
The Nemours Foundation Multi-Specialty Past Accepting new patients

Locations

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

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": "1603843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1053911156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2039 SAINT ALBANS ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461334",
            "telephone_number": "610-737-6228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044274",
            "telephone_number": "215-316-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEMPLETON",
        "first_name": "JORDAN",
        "middle_name": "CHARLES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-28",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA061977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.