Individual provider Active NPI

Jessica Barrett Kordansky, PHD

  • Counseling Psychologist
  • Boca Raton, FL
National Provider Identifier
1104107937
Registry record updated Feb 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
PY8369 Issued in FL
Practice address
399 NW 2ND Ave
Suite 202
Boca Raton, FL 33432-3845
Phone
(561) 318-1743
Fax
(561) 953-9238
NPI assigned
Sep 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X PY8369 FL Primary

Addresses

Primary practice location

399 NW 2ND Ave
Suite 202
Boca Raton, FL 33432-3845

Mailing address

399 NW 2ND Ave
Suite 202
Boca Raton, FL 33432-3845
Phone (561) 318-1743

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111227000150 FL Practitioner - Clinical Psychologist 8820264724 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

399 NW 2ND Ave
Suite 202
Boca Raton, FL 33432-3794
Phone (561) 318-1743

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY8369FLMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Jessica B. Kordansky, PA CurrentSince Jan 7, 2014 Accepting new patients

Locations

399 NW 2nd Ave
Ste 202
Boca Raton, FL 33432
Phone (561) 318-1743

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.

NPI Registry JSON

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

{
    "created_epoch": "1315353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393459200000",
    "number": "1104107937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "399 NW 2ND AVE",
            "address_2": "SUITE 202",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334323845",
            "telephone_number": "561-318-1743",
            "fax_number": "561-953-9238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 NW 2ND AVE",
            "address_2": "SUITE 202",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334323845",
            "telephone_number": "561-318-1743",
            "fax_number": "561-953-9238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORDANSKY",
        "first_name": "JESSICA",
        "middle_name": "BARRETT",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-07",
        "last_updated": "2014-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "FL",
            "license": "PY8369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.