Individual provider Active NPI

Avra Jordano-Alter, M.D.

  • Obstetrics & Gynecology Physician
  • Concord, MA
National Provider Identifier
1104818392
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
158912 Issued in MA
Practice address
59 Ornac
Suite 1
Concord, MA 01742-3317
Phone
(978) 369-7627
Fax
(978) 371-2240
NPI assigned
Aug 16, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 158912 MA Primary

Addresses

Primary practice location

59 Ornac
Suite 1
Concord, MA 01742-3317

Mailing address

59 Ornac
Suite 1
Concord, MA 01742-3317
Phone (978) 369-7627

Other identifiers 1

IdentifierTypeStateIssuer
3195759MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20090414000607 MA Practitioner - Obstetrics/Gynecology 9830257286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
State University of New York Downstate Medical Center, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2 Lan Dr
Suite 203
Westford, MA 01886-3550
Phone (978) 850-3365

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Diagnostic Services, Inc CurrentSince Jan 1, 2008 Accepting new patients
One to One GYN Westford PC Obstetrics & Gynecology CurrentSince Nov 1, 2020 Accepting new patients

Locations

59 Ornac
#1
Concord, MA 01742
Phone (978) 369-7627

2 Lan Dr
Ste 203
Westford, MA 01886
Phone (978) 850-3355

Organizations & group practices 3

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.

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104818392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 ORNAC",
            "address_2": "SUITE 1",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017423317",
            "telephone_number": "978-369-7627",
            "fax_number": "978-371-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 ORNAC",
            "address_2": "SUITE 1",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017423317",
            "telephone_number": "978-369-7627",
            "fax_number": "978-371-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDANO-ALTER",
        "first_name": "AVRA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "158912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3195759",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

Verify at the official NPI Registry.