Individual provider Active NPI

Eric Michael Jorgensen, MD

  • Allergy & Immunology Physician
  • Ithaca, NY
National Provider Identifier
1093371429
Registry record updated Jun 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
311096 Issued in NY
Practice address
904 E Shore Dr
Ithaca, NY 14850-1026
Phone
(607) 257-6563
NPI assigned
May 10, 2019
Last updated
Jun 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 311096 NY Primary

Addresses

Primary practice location

904 E Shore Dr
Ithaca, NY 14850-1026

Mailing address

904 E Shore Dr
Ithaca, NY 14850-1026
Phone (607) 257-6563

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
I20250630000362 NY Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 4880925981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Internal Medicine
Education
State University of New York at Buffalo School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Asthma and Allergy Associates PCGroup PAC ID 0840216388, 7 clinicians

Practice addresses (Care Compare)

904 E Shore Dr
Ithaca, NY 14850-1026
Phone (607) 257-6563

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
311096NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Asthma & Allergy Associates P.C. CurrentSince Aug 1, 2025 Accepting new patients

Locations

3533 State Route 281
#B
Cortland, NY 13045
Phone (607) 753-9604

216 W Gray St
Elmira, NY 14901
Phone (607) 733-5086

4000 Medical Center Dr
Ste 101D
Fayetteville, NY 13066
Phone (315) 478-3311

4000 Medical Center Dr
Ste 402
Fayetteville, NY 13066
Phone (315) 663-0005

904 E Shore Dr
Ithaca, NY 14850
Phone (607) 257-6563

1550 Vestal Pkwy E
Ste 4
Vestal, NY 13850
Phone (607) 766-0235

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, 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": "1557446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750464000000",
    "number": "1093371429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 E SHORE DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501026",
            "telephone_number": "607-257-6563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 E SHORE DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501026",
            "telephone_number": "607-257-6563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORGENSEN",
        "first_name": "ERIC",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-10",
        "last_updated": "2025-06-21",
        "certification_date": "2025-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NY",
            "license": "311096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.