Jordan Delynn Pendleton

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00558600 Issued in NJ

Practice address

176 Palisade Ave
Jersey City, NJ 07306-1121

Phone

(201) 795-8200

NPI assigned

Oct 16, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Somerset Valley Urgent Care, L.L.C. 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Somerset Valley Urgent Care, L.L.C.

  • Urgent Care Clinic/Center
  • Bedminster, NJ
  • NPI 1730330655

  NJ

  Medicare reassignment Care Compare group
• Garden State Healthcare Associates, LLC

  • Emergency Medicine Physician
  • Bayonne, NJ
  • NPI 1700014545

  NJ

  Medicare reassignment
• Ihpnj ER LLC

  • Emergency Medicine Physician
  • Hoboken, NJ
  • NPI 1225750946

  NJ

  Medicare reassignment
• Rwjbh Emergency Medicine Associates, LLC

  • Emergency Medicine Physician
  • Somerset, NJ
  • NPI 1912510041

  NJ

  Medicare reassignment
• Rwjbh Observation Associates LLC

  • Emergency Medicine Physician
  • Livingston, NJ
  • NPI 1760095806

  NJ

  Medicare reassignment

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

{
    "created_epoch": "1571184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1104468651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 PALISADE AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073061121",
            "telephone_number": "201-795-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 PALISADE AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073061121",
            "telephone_number": "201-795-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDLETON",
        "first_name": "JORDAN",
        "middle_name": "DELYNN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-16",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00558600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ralph Pellecchia, M.D.
• Matthew Peltz
• Carissa Pelzel, FNP
• Krishna C Pendem
• Kelly Anne Pender, LMT
• Pennreach
• Pennreach
• Pennreach
• People 2 People
• Peter A. Peregrin, P.A.

• All providers in Jersey City, NJ
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.