Active NPI
Sara Jordan, MSN, APRN, AGACNP-BC
- Nurse Practitioner
- Worcester, MA
National Provider Identifier
1245707348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- RN2336410
- Practice address
- 55 Lake Ave N
Worcester, MA 01655-0002 - Phone
- (508) 334-3728
- Fax
- (508) 334-7284
- NPI assigned
- Oct 26, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 5011161 | NC | |
| Nurse Practitioner | 363L00000X | RN2336410 | MA | Primary |
Addresses
Primary practice location
55 Lake Ave N
Worcester, MA 01655-0002
Mailing address
PO Box 415348
Boston, MA 02241-5348
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | sjordan307854@UmassMemorial.direct-ci.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN2336410 | MA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Umass Memorial Medical Center, Inc. | Current | Accepting new patients | |
| Umass Memorial Medical Group, Inc. | Current | Accepting new patients | |
| Umass Memorial Medical Center, Inc. | Current | Accepting new patients | |
| Umass Memorial Medical Group Inc | Nurse Practitioner | Current | Accepting new patients |
Locations
55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862
Interoperability endpoints
- sjordan307854@umassmemorial.direct-ci.com
Organizations & group practices 4
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.
-
- Psychiatric Hospital Unit
- Worcester, MA
- NPI 1689760092
-
- Internal Medicine Physician
- Worcester, MA
- NPI 1760445373
Nurse Practitioner
-
- General Acute Care Hospital
- Marlborough, MA
- NPI 1396738159
-
- Urgent Care Clinic/Center
- Oxford, MA
- NPI 1982381018
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604448000000",
"number": "1245707348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 415348",
"city": "BOSTON",
"state": "MA",
"postal_code": "022415348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 LAKE AVE N",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016550002",
"telephone_number": "508-334-3728",
"fax_number": "508-334-7284"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "SARA",
"credential": "MSN, APRN, AGACNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-26",
"last_updated": "2020-11-04",
"certification_date": "2020-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "NC",
"license": "5011161",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MA",
"license": "RN2336410",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "55 Lake Ave N",
"city": "Worcester",
"state": "MA",
"country_code": "US",
"postal_code": "016550002",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sjordan307854@UmassMemorial.direct-ci.com",
"affiliation": "N",
"address_1": "55 Lake Ave N",
"city": "Worcester",
"state": "MA",
"country_code": "US",
"postal_code": "016550002",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.