Individual provider Active NPI

Jordan L Lalonde, PA-C

  • Physician Assistant
  • San Leandro, CA
National Provider Identifier
1063763977
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA58009 Issued in CA
Practice address
13855 E 14TH St
San Leandro, CA 94578-2611
Phone
(510) 357-6500
NPI assigned
Oct 2, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X P85937 NY
Physician Assistant 363A00000X PA58009 CA Primary

Addresses

Primary practice location

13855 E 14TH St
San Leandro, CA 94578-2611

Mailing address

419 Santa Clara Ave
Alameda, CA 94501-3242
Phone (605) 864-3318

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200813001478 CA Practitioner - Physician Assistant 7113179763 Reassigns benefits to 1 organization
I20200917001109 AZ Practitioner - Physician Assistant 7113179763 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alameda Health SystemGroup PAC ID 3779494521, 597 clinicians

Practice addresses (Care Compare)

1411 E 31St St
Oakland, CA 94602-1018
Phone (510) 437-4800

2070 Clinton Ave
Alameda, CA 94501-4399
Phone (510) 522-3700

Hospital & facility affiliations

  • Copper Queen Community Hospital Hospital, Bisbee, AZ, CCN 031312

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58009CAMDDental Assistant
PA58009CAMDPhysician Assistant
P85937NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alameda Health System Current Accepting new patients
Bisbee Hospital Association CurrentSince Aug 1, 2020 Accepting new patients
Bisbee Hospital Association CurrentSince Aug 1, 2020 Accepting new patients
Bisbee Hospital Association CurrentSince Jan 1, 2024 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients
Alameda Health System Past Accepting new patients

Locations

101 Cole Ave
Bisbee, AZ 85603
Phone (520) 432-5383

100 E 5th St
Douglas, AZ 85607
Phone (520) 364-7659

2070 Clinton Ave
Alameda, CA 94501
Phone (510) 522-3700

1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323

13855 E 14th St
San Leandro, CA 94578
Phone (510) 357-6500

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1063763977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 SANTA CLARA AVE",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945013242",
            "telephone_number": "605-864-3318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13855 E 14TH ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945782611",
            "telephone_number": "510-357-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LALONDE",
        "first_name": "JORDAN",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-02",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "P85937",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA58009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

Verify at the official NPI Registry.