Individual provider Active NPI

Jordan Storkersen

  • Emergency Medicine Physician
  • Colton, CA
National Provider Identifier
1114580651
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A184035 Issued in CA
Practice address
400 N Pepper Ave Ste 107
Colton, CA 92324-1819
Phone
(909) 580-1862
NPI assigned
Apr 19, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X A184035 CA Primary

Addresses

Primary practice location

400 N Pepper Ave Ste 107
Colton, CA 92324-1819

Mailing address

400 N Pepper Ave Ste 107
Colton, CA 92324-1801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20230327002914 CA Practitioner - Emergency Medicine 1951775261 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - CaliforniaGroup PAC ID 6103739131, 1,278 clinicians

Practice addresses (Care Compare)

900 Hyde St
San Francisco, CA 94109-4806
Phone (415) 353-6000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group CurrentSince Feb 18, 2023 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Jul 26, 2024 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Feb 18, 2023 Accepting new patients
Healthcare Partners Affiliates Medical Group Current Accepting new patients
Cep America - California Emergency Medicine CurrentSince Jul 26, 2024 Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

400 N Pepper Ave
Ste 107
Colton, CA 92324
Phone (909) 580-1862

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

450 Stanyan St
San Francisco, CA 94117
Phone (415) 668-1000

900 Hyde St
San Francisco, CA 94109
Phone (415) 353-6000

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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": "1555632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1114580651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE STE 107",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE STE 107",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241819",
            "telephone_number": "909-580-1862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORKERSEN",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-19",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A184035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

Verify at the official NPI Registry.