Jordan R Alter, MD
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · New Haven, CT
NPI 1336726397 · NPPES record last updated Aug 10, 2024
Key facts
- NPI
- 1336726397
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- License
- 78841 (CT)
- Practice address
- 20 York St
New Haven, CT 06510-3220 - Phone
- (203) 688-4242
- NPI assigned
- Mar 25, 2021
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210715000981 | MA | Order and Referring Only - Pediatric Medicine |
4385046291 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 78841 | CT | MD | Student in an Organized Health Care Education/Training Program |
Interoperability endpoints
- jalter659888@direct.ynhh.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 78841 | CT | Yes |
Addresses
Primary practice location
20 York St
New Haven, CT 06510-3220
Mailing address
20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242
Other providers in New Haven, CT
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- Robina Altbrandt
- Chloe Altchek
- Ahmed M.a. Altibi
- Frederick Lewis Altice
- Henry Drakulich Altick
- Sophia Elissa Altin
- Casey J Altomaro
All providers in New Haven, CT · Student in an Organized Health Care Education/Training Program in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.