Jordan Nicole Feltis

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9118265 Issued in FL

Practice address

5808 S Jog Rd
Lake Worth, FL 33467-6511

Phone

(561) 968-7546

NPI assigned

Dec 15, 2023

Last updated

Sep 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, NY2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bobby Buka, M.D., P.C.Group PAC ID 0547351140, 140 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Bobby Buka, M.D., P.C.

  • Dermatology Physician
  • New York, NY
  • NPI 1134349954
  Medicare reassignment Care Compare group
• Dermatology Center of the Palm Beaches PA

  • Dermatology Physician
  • Lake Worth, FL
  • NPI 1497359426
  Medicare reassignment

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

{
    "created_epoch": "1702598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1154199479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 GINGER CIR",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333263628",
            "telephone_number": "954-873-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5808 S JOG RD",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334676511",
            "telephone_number": "561-968-7546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 S Federal Hwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Deerfield Beach",
            "state": "FL",
            "postal_code": "334417000",
            "country_code": "US",
            "telephone_number": "954-943-9670",
            "fax_number": "954-943-9671",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "715 W Boynton Beach Blvd Ste C",
            "address_purpose": "LOCATION",
            "city": "Boynton Beach",
            "state": "FL",
            "postal_code": "334263625",
            "country_code": "US",
            "telephone_number": "561-968-7546",
            "fax_number": "561-968-1143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FELTIS",
        "first_name": "JORDAN",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-15",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9118265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ana Fatani, MS, RMHCI
• Nideline Faustin
• Michelle Fein, PSY.D.
• Dennis Feinrider, MD
• Felicidad Health Center PA
• Jamya Felton
• Shirley Lena Fenelus
• Fenix Rising Medical LLC
• Fenix Therapeutic Services
• Terri Ferguson, LCSW

• Physician Assistant in Lake Worth, FL
• Providers in Lake Worth, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.