NPIMap

Individual provider Active NPI

Jordan Kelly Magruder, MD

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1619469061
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
314349 Issued in NY
Practice address
1 Brookdale PLZ
Brooklyn, NY 11212-3139
Phone
(718) 240-5000
NPI assigned
Jun 1, 2018
Last updated
Jul 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 314349 NY Primary

Addresses

Primary practice location

1 Brookdale PLZ
Brooklyn, NY 11212-3139

Mailing address

483 Ocean Pkwy Ste LB
Brooklyn, NY 11218-5147
Phone (602) 769-2115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220602001695 NY Practitioner - Internal Medicine 7012395064 Reassigns benefits to 3 organizations
I20240620003426 PA Practitioner - Hospice/Palliative CarePractitioner - Internal Medicine 7012395064 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative CareAlso: Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Guthrie Medical Group PCGroup PAC ID 6002728656, shared by 5 NPIs, 795 clinicians

Practice addresses (Care Compare)

1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858

130 Ctr Way
Corning, NY 14830-2255
Phone (607) 936-9971

One Guthrie SQ
Sayre, PA 18840-1625

One Guthrie Square
Sayre, PA 18840-1625

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.13 of 100Reported as group
Quality
77.56
Promoting interoperability
100
Improvement activities
40
Cost
76.02

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
314349NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guthrie Medical Group, P.C. CurrentSince Jul 15, 2024 Accepting new patients
Guthrie Medical Group, P.C. Internal Medicine CurrentSince Jul 15, 2024 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Jul 15, 2024 Accepting new patients
Interfaith Professional Physician Services, P.C. Internal Medicine CurrentSince Mar 9, 2024 Accepting new patients
The Brookdale Hospital Medical Center CurrentSince May 1, 2022 Accepting new patients
Brookdale Hospital Medical Center CurrentSince May 1, 2022 Accepting new patients
Guthrie Medical Group, P.C. Current Accepting new patients

Locations

1 Brookdale Plz
Brooklyn, NY 11212
Phone (718) 240-5212

1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

130 Center Way
Corning, NY 14830
Phone (607) 936-9971

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

Interoperability endpoints

  • Direct secure messaging: jmagruder203757@direct-guthrie.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Guthrie HospiceTowanda, PA, CCN 391564 Hospice Corporate Director Jan 28, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1527811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1619469061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 OCEAN PKWY STE LB",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112185147",
            "telephone_number": "602-769-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BROOKDALE PLZ",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112123139",
            "telephone_number": "718-240-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGRUDER",
        "first_name": "JORDAN",
        "middle_name": "KELLY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-01",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "314349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.