Jordan William Waddell, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

10 Lincoln SQ
Worcester, MA 01608-1135

Phone

(970) 673-3828

NPI assigned

Aug 2, 2023

Sex

Male

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 ME, NH2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Dermatology Associates PCGroup PAC ID 3072403799, 84 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwaddell@nedermatology.emadirect.md
• Direct secure messaging: jordan.waddell@pd.eclinicaldirectplus.com

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.

• Northeast Dermatology Associates, PC

  • Specialist
  • North Andover, MA
  • NPI 1104921162

  ME

  Medicare reassignment Care Compare group NPD
• Northeast Dermatology Associates, PC

  • Specialist
  • Exeter, NH
  • NPI 1508061839
  Medicare reassignment
• Neda at North Shore PC

  • Dermatology Physician
  • Marblehead, MA
  • NPI 1902345861
  NPD

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

{
    "created_epoch": "1690934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1558043398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 LINCOLN SQ",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081135",
            "telephone_number": "970-673-3828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 LINCOLN SQ",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081135",
            "telephone_number": "970-673-3828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADDELL",
        "first_name": "JORDAN",
        "middle_name": "WILLIAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-02",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mikhail Vydrin, M.D.
• Lillian Wabula
• Megan B Wachsmann, M.D.
• Wachusett Dental PLLC
• Marlene Wacks
• Zuleikha Wadhwaniya
• Melanie Wadsworth
• Husnia Wafa
• Andrew B Wagg Sr.
• Puneeta K. Wagholikar, MD

• Physician Assistant in Worcester, MA
• Providers in Worcester, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; 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.