Individual provider Active NPI

Jordan Michael Silidker, PA

  • Surgical Physician Assistant
  • Hartford, CT
National Provider Identifier
1437603776
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
003688 Issued in CT
Practice address
80 Seymour Street
Hartford Hospital Surgery Dept.
Hartford, CT 06102-5037
Phone
(860) 972-5022
NPI assigned
Aug 3, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 003688 CT
Medical Physician Assistant 363AM0700X 003688 CT
Surgical Physician Assistant 363AS0400X 003688 CT Primary

Addresses

Primary practice location

80 Seymour Street
Hartford Hospital Surgery Dept.
Hartford, CT 06102-5037

Mailing address

80 Seymour Street
Hartford Hospital Surgery Dept.
Hartford, CT 06102-5037
Phone (860) 972-5022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20170119000273 CT Practitioner - Physician Assistant 0244512606 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
003688CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Hospital CurrentSince Feb 22, 2017 Accepting new patients
Hartford Healthcare Medical Group, Inc Physician Assistant CurrentSince Jan 1, 2017 Accepting new patients

Locations

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

Interoperability endpoints

  • Direct secure messaging: jsilidker317904@direct.ynhh.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1470182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1437603776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR STREET",
            "address_2": "HARTFORD HOSPITAL SURGERY DEPT.",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061025037",
            "telephone_number": "860-972-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR STREET",
            "address_2": "HARTFORD HOSPITAL SURGERY DEPT.",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061025037",
            "telephone_number": "860-972-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILIDKER",
        "first_name": "JORDAN",
        "middle_name": "MICHAEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-03",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "003688",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "003688",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "003688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.