NPIMap

Individual provider Active NPI

Jordan Carl Weber, PA-C

  • Physician Assistant
  • Wagner, SD
National Provider Identifier
1427322957
Registry record updated Aug 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0959 Issued in SD
Practice address
513 3Rd St SW
Wagner, SD 57380-9675
Phone
(605) 384-3418
Fax
(605) 384-5240
NPI assigned
Mar 1, 2012
Last updated
Aug 21, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0959 SD Primary

Addresses

Primary practice location

513 3Rd St SW
Wagner, SD 57380-9675

Mailing address

513 3Rd St SW
Wagner, SD 57380-9675
Phone (605) 384-3418

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150410000917 SD Practitioner - Physician Assistant 8820316417 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wagner Community Memorial HospitalGroup PAC ID 3577459700, shared by 3 NPIs, 17 clinicians

Practice addresses (Care Compare)

513 3Rd St SW
Wagner, SD 57380-9675
Phone (605) 384-3418

513 3Rd SW St
Wagner, SD 57380-9675

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.55 of 100Reported as group
Quality
66.54
Promoting interoperability
100
Improvement activities
40
Cost
45.26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0959SDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wagner Community Memorial Hospital CurrentSince Nov 27, 2025 Accepting new patients
Wagner Community Memorial Hospital Physician Assistant CurrentSince Apr 6, 2015 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jordan.weber@avera.sdhealthlink.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1330560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1427322957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 3RD ST SW",
            "city": "WAGNER",
            "state": "SD",
            "postal_code": "573809675",
            "telephone_number": "605-384-3418",
            "fax_number": "605-384-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 3RD ST SW",
            "city": "WAGNER",
            "state": "SD",
            "postal_code": "573809675",
            "telephone_number": "605-384-3418",
            "fax_number": "605-384-5240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "JORDAN",
        "middle_name": "CARL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-01",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wagner, SD

Sources for this page

Verify at the official NPI Registry.