Individual provider Active NPI

Jordan June Stein, PA-C

  • Physician Assistant
  • Fort Wayne, IN
National Provider Identifier
1104593698
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10003352A Issued in IN
Practice address
11109 Parkview Plaza Dr
Fort Wayne, IN 46845-1701
Phone
(260) 498-2022
NPI assigned
Aug 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10003352A IN Primary

Addresses

Primary practice location

11109 Parkview Plaza Dr
Fort Wayne, IN 46845-1701

Mailing address

608 Union Chapel Rd
Fort Wayne, IN 46845-9357
Phone (260) 388-9109

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20210927001860 IN Practitioner - Physician Assistant 9032516547 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.38 of 100Reported as group
Quality
87.23
Promoting interoperability
100
Improvement activities
40
Cost
83.74

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Oct 15, 2022 Accepting new patients
Cep America LLC CurrentSince Oct 15, 2022 Accepting new patients
Interventional Pain Consultants, LLC PastSince Feb 20, 2009 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

3700 Washington Ave
Evansville, IN 47714
Phone (812) 232-0021

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

Interoperability endpoints

  • Direct secure messaging: jstein659202@direct.parkviewexchange.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1104593698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 UNION CHAPEL RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468459357",
            "telephone_number": "260-388-9109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701",
            "telephone_number": "260-498-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEIN",
        "first_name": "JORDAN",
        "middle_name": "JUNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-24",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003352A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.