Individual provider Active NPI

Jordan Swanson, M.D.

  • Plastic Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1477719409
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
MD461479 Issued in PA
Practice address
3401 Civic Center Blvd
Children'S Surgical Associates
Philadelphia, PA 19107-4319
Phone
(267) 425-9538
Fax
(267) 425-9552
NPI assigned
Jul 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X A137620 CA
Plastic Surgery Physician 208200000X MD461479 PA Primary

Addresses

Primary practice location

3401 Civic Center Blvd
Children'S Surgical Associates
Philadelphia, PA 19107-4319

Mailing address

PO Box 8500 Lockbox #7642
Philadelphia, PA 19178-7642
Phone (813) 281-8478

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171020000121 PA Practitioner - Plastic and Reconstructive Surgery 5395011274 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Johns Hopkins University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3401 Civic Ctr Blvd
Philadelphia, PA 19104-4319
Phone (267) 425-9505

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A137620CAMDPlastic Surgery Physician
MD461479PAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shriners Hospitals for Children CurrentSince Mar 24, 2018 Accepting new patients
Shriners Hospitals for Children CurrentSince Mar 24, 2018 Accepting new patients
Children'S Surgical Associates LTD Past Accepting new patients
Children'S Surgical Associates LTD Past Accepting new patients
Children'S Surgical Associates LTD Plastic Surgery Past Accepting new patients
Childrens Hospital of Philadelphia Past Accepting new patients

Locations

3551 N Broad St
Philadelphia, PA 19140
Phone (215) 430-4000

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1477719409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8500 LOCKBOX #7642",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191787642",
            "telephone_number": "813-281-8478",
            "fax_number": "813-281-8113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "CHILDREN'S SURGICAL ASSOCIATES",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074319",
            "telephone_number": "267-425-9538",
            "fax_number": "267-425-9552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A137620",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "PA",
            "license": "MD461479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.