Jennifer Jean Jordan, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA04718 Issued in TX

Practice address

5145 FM 620 N Ste B-110
Austin, TX 78732-1815

Phone

(512) 266-0007

Fax

(512) 266-0077

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Physician Assistant

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sanova Dermatology PLLCGroup PAC ID 8527235340, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Sanova Dermatology PLLC

  • Dermatology Physician
  • Austin, TX
  • NPI 1689957169

  TX

  Medicare reassignment Care Compare group
• Austin Dermatology Clinic, PA

  • Dermatology Physician
  • Austin, TX
  • NPI 1861501736
  NPD (past)
• Dermatology Consultants of Frisco, P.a.

  • Dermatology Physician
  • Frisco, TX
  • NPI 1912194481

  Procedural Dermatology

  NPD (past)
• PDP of Texas, PLLC

  • Dermatology Physician
  • Dallas, TX
  • NPI 1629025739

  Procedural Dermatology

  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589155200000",
    "number": "1164534699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5145 FM 620 N STE B-110",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787321815",
            "telephone_number": "512-266-0007",
            "fax_number": "512-266-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5145 FM 620 N STE B-110",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787321815",
            "telephone_number": "512-266-0007",
            "fax_number": "512-266-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "JENNIFER",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "TX",
            "license": "PA04718",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA04718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00393129",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Denise Jordan
• Eric L Jordan, C.PED
• Janette Lynn Jordan, LCSW, LMFT
• Janis Anderson Jordan, MS, LPC, LMFT
• Jennefer Christine Jordan, DNP, FNP-BC
• Joseph Lee Jordan
• Krista Diane Jordan, PHD
• Madeleine Marie Jordan, MD
• Mandy J Jordan, PHD
• Ryan Jordan

• Medical Physician Assistant in Austin, TX
• Providers in Austin, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.

Verify at the official NPI Registry.