Active NPI
Jordan Alexander Drelich, RPA-C
- Physician Assistant
- Bronx, NY
National Provider Identifier
1225548514
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 021415-1
- Practice address
- 1650 Grand Concourse
Bronx, NY 10457-7606 - Phone
- (718) 466-8132
- NPI assigned
- Oct 2, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 021415-1 | NY | Primary |
Addresses
Primary practice location
1650 Grand Concourse
Bronx, NY 10457-7606
Mailing address
1276 Fulton Ave
RM 208
Bronx, NY 10456-3402
Phone (631) 462-6882
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021415 | NY | MD | Psychologist |
| 021415-1 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1506902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508457600000",
"number": "1225548514",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1276 FULTON AVE",
"address_2": "RM 208",
"city": "BRONX",
"state": "NY",
"postal_code": "104563402",
"telephone_number": "631-462-6882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 GRAND CONCOURSE",
"city": "BRONX",
"state": "NY",
"postal_code": "104577606",
"telephone_number": "718-466-8132"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRELICH",
"first_name": "JORDAN",
"middle_name": "ALEXANDER",
"credential": "RPA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-10-02",
"last_updated": "2017-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "021415-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.