Active NPI
George Reginald Jordan, M.D.
- Dermatology Physician
- New York, NY
National Provider Identifier
1346329141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 099834
- Practice address
- 1879 Madison Ave
6TH FLR
New York, NY 10035-2709 - Phone
- (212) 423-4500
- Fax
- (212) 423-1404
- NPI assigned
- Nov 3, 2006
- 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 |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 099834 | NY | Primary |
Addresses
Primary practice location
1879 Madison Ave
6TH FLR
New York, NY 10035-2709
Mailing address
1879 Madison Ave
6TH FLR
New York, NY 10035-2709
Phone (212) 423-4500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00427110 | Medicaid | NY |
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
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| JHMC Diagnostic and Treatment Center | Dermatology | Past | Accepting new patients |
| North General Physician Services PLLC | Dermatology | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Jamaica, NY
- NPI 1821045485
Dermatology
-
- Internal Medicine Physician
- New York, NY
- NPI 1851315337
Dermatology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192060800000",
"number": "1346329141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1879 MADISON AVE",
"address_2": "6TH FLR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100352709",
"telephone_number": "212-423-4500",
"fax_number": "212-423-1404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1879 MADISON AVE",
"address_2": "6TH FLR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100352709",
"telephone_number": "212-423-4500",
"fax_number": "212-423-1404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "GEORGE",
"middle_name": "REGINALD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-03",
"last_updated": "2007-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NY",
"license": "099834",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00427110",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.