Anthony Carroll Jordan, PA-S

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1427 Jefferson Ave
Suite 101
Enumclaw, WA 98022-3649

Phone

(360) 825-4466

NPI assigned

Aug 19, 2014

Last updated

Sep 23, 2014By the provider in NPPES

Sex

Male

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 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

Merit-based Incentive Payment System (MIPS)

Final score

80.19 of 100Reported as group

Quality

60.38

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Muckleshoot Indian Tribe

  dba Muckleshoot Health and Wellness Center

  • Clinic/Center
  • Auburn, WA
  • NPI 1558448175

  TX

  Medicare reassignment

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

{
    "created_epoch": "1408406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411430400000",
    "number": "1336548064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1427 JEFFERSON AVE",
            "address_2": "SUITE 101",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980223649",
            "telephone_number": "360-825-4466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1427 JEFFERSON AVE",
            "address_2": "SUITE 101",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980223649",
            "telephone_number": "360-825-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "ANTHONY",
        "middle_name": "CARROLL",
        "name_prefix": "Mr.",
        "credential": "PA-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-19",
        "last_updated": "2014-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Scott Israel, RPH
• James E Johnson DDS PS
• Janet Gay Kurz (Counseling For Growth)
• James Eric Johnson, DDS
• Janene Ruth Johnson, PTA
• Roberta Jowell, LPN
• Michael A Kay, DDS
• Gouhar Yusuof Khan, M.D.
• Joyce Wangui Kibui, PHARMD
• Terri Lynn Kilbourne, MA 00004895

• Physician Assistant in Enumclaw, WA
• Providers in Enumclaw, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2014; 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.