Individual provider Active NPI

Jordan John Jepson, PA

  • Surgical Physician Assistant
  • Turlock, CA
National Provider Identifier
1467010744
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA56842 Issued in CA
Practice address
1000 Delbon Ave Ste 8
Turlock, CA 95382
Phone
(209) 226-4644
NPI assigned
Jun 3, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA56842 CA
Surgical Physician Assistant 363AS0400X PA56842 CA Primary

Addresses

Primary practice location

1000 Delbon Ave Ste 8
Turlock, CA 95382

Mailing address

1000 Delbon Ave Ste 8
Turlock, CA 95382-2008
Phone (209) 226-4644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20190716002341 CA Practitioner - Physician Assistant 4587999347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Golden State Dermatology Associates, Inc.Group PAC ID 1052418175, 118 clinicians

Practice addresses (Care Compare)

1000 Delbon Ave
Suite 8
Turlock, CA 95382-2008
Phone (209) 226-4644

355 Lennon LN
Suite 255
Walnut Creek, CA 94598-2496
Phone (925) 932-7704

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA56842CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Dermatology Associates, Inc. CurrentSince Jul 1, 2019 Accepting new patients

Locations

1200 Central Blvd
Ste D
Brentwood, CA 94513
Phone (925) 308-9510

1000 Delbon Ave
Ste 8
Turlock, CA 95382
Phone (209) 226-4644

370 N Wiget Ln
Ste 250
Walnut Creek, CA 94598
Phone (925) 278-7592

355 Lennon Ln
Ste 255
Walnut Creek, CA 94598
Phone (925) 932-7704

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": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1467010744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 DELBON AVE STE 8",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953822008",
            "telephone_number": "209-226-4644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 DELBON AVE STE 8",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "95382",
            "telephone_number": "209-226-4644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEPSON",
        "first_name": "JORDAN",
        "middle_name": "JOHN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-03",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA56842",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA56842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Turlock, CA

Sources for this page

Verify at the official NPI Registry.