Active NPI
Jordan Marcou, PA-C
- Physician Assistant
- Trumbull, CT
National Provider Identifier
1154834786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 4008
- Practice address
- 5520 Park Ave
Trumbull, CT 06611 - Phone
- (203) 373-7330
- NPI assigned
- Nov 6, 2017
- Last updated
- Jul 1, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | |||
| Physician Assistant | 363A00000X | 4008 | CT | Primary |
Addresses
Primary practice location
5520 Park Ave
Trumbull, CT 06611
Mailing address
52 Beach Rd Ste 104
Fairfield, CT 06824-6692
Phone (203) 254-3570
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
52 Beach Rd
Suite 104
Fairfield, CT 06824-6017
Phone (203) 254-2000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593561600000",
"number": "1154834786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "52 BEACH RD STE 104",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068246692",
"telephone_number": "203-254-3570",
"fax_number": "203-255-3126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5520 PARK AVE",
"city": "TRUMBULL",
"state": "CT",
"postal_code": "06611",
"telephone_number": "203-373-7330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCOU",
"first_name": "JORDAN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-11-06",
"last_updated": "2020-07-01",
"certification_date": "2020-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CT",
"license": "4008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Trumbull, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.