Jordan Carla Shaffer, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA057150 Issued in PA

Practice address

3400 Civic Center Blvd
Nephrology/Hypertension
Philadelphia, PA 19104-5127

Phone

(215) 662-2638

NPI assigned

Aug 25, 2014

Sex

Female

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 DC

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Medstar Medical Group II LLC

  • General Practice Physician
  • Baltimore, MD
  • NPI 1184046187

  DC

  Medicare reassignment NPD
• Medstar Medical Group II LLC

  • Anatomic Pathology Physician
  • Washington, DC
  • NPI 1578297503
  NPD
• University of Penn - Medical Group

  • Nephrology Physician
  • Philadelphia, PA
  • NPI 1629181912
  NPD (past)
• Medstar Medical Group II LLC

  • Internal Medicine Physician
  • Washington, DC
  • NPI 1376887844
  NPD (past)

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

{
    "created_epoch": "1408924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474329600000",
    "number": "1427458728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "address_2": "NEPHROLOGY/HYPERTENSION",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-662-2638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "address_2": "NEPHROLOGY/HYPERTENSION",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-662-2638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "JORDAN",
        "middle_name": "CARLA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-25",
        "last_updated": "2016-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA057150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Omid Shafaat, MD
• Frank Edward Shafer, M.D.
• Hannah Elise Shafer, PA-C
• Andrew Shaffer
• Gene W Shaffer, MD
• Katherine Anne Shaffer, MD
• Lauren Rose Shaffer, MD
• Martina Shaffer, CRNA
• Rose B. Shaffer, CRNP
• Badar Bin Bilal Shafi

• Physician Assistant in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; 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.