Individual provider Active NPI

Richard Jordan, M.D.

  • Internal Medicine Physician
  • South Gate, CA
National Provider Identifier
1639212558
Registry record updated Sep 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A94116 Issued in CA
Practice address
4476 Tweedy Blvd
South Gate, CA 90280-6359
Phone
(323) 563-9499
Fax
(323) 563-0956
NPI assigned
Feb 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A94116 CA Primary

Addresses

Primary practice location

4476 Tweedy Blvd
South Gate, CA 90280-6359

Mailing address

75 Remittance Drive
Dept 6008
Chicago, IL 60675-6008
Phone (262) 282-1419

Other identifiers 1

IdentifierTypeStateIssuer
00A94160MedicaidCA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130723000701 CA Practitioner - Internal Medicine 1456592187 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of California, Geffen School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pih Health PhysiciansGroup PAC ID 8426951328, 616 clinicians

Practice addresses (Care Compare)

11500 Brookshire Ave
Downey, CA 90241-4917
Phone (562) 904-5000

12675 La Mirada Blvd
Suite 201And401
La Mirada, CA 90638-2200
Phone (562) 903-7339

4476 Tweedy Blvd
South Gate, CA 90280-6359
Phone (323) 563-9499

Hospital & facility affiliations

  • Pih Health Downey Hospital Hospital, Downey, CA, CCN 050393

Merit-based Incentive Payment System (MIPS)

Final score
78.61 of 100Reported as group
Quality
58.7
Improvement activities
40
Cost
75.08

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A94116CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pih Health Physicians Current Accepting new patients
Pih Health Physicians CurrentSince Aug 15, 2020 Accepting new patients
Pih Health Physicians CurrentSince Aug 15, 2020 Accepting new patients
Pioneer Medical Group Inc. CurrentSince Jun 17, 2013 Accepting new patients
Bright Medical Associates, Inc. Past Accepting new patients
University of California Irvine Past Accepting new patients
Los Alamitos Medical Center, Inc. Past Accepting new patients
Pih Health Downey Hospital Past Accepting new patients

Locations

17777 Center Court Dr N
Ste 400
Cerritos, CA 90703
Phone (562) 229-9452

12675 La Mirada Blvd
Ste 201401
La Mirada, CA 90638
Phone (562) 903-7339

2220 Clark Ave
Long Beach, CA 90815
Phone (562) 597-4181

4476 Tweedy Blvd
South Gate, CA 90280
Phone (323) 563-9499

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: richardjordan@pihh.allscriptsdirect.net

Organizations & group practices 8

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": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474416000000",
    "number": "1639212558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 REMITTANCE DRIVE",
            "address_2": "DEPT 6008",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606756008",
            "telephone_number": "262-282-1419",
            "fax_number": "562-920-4642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4476 TWEEDY BLVD",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902806359",
            "telephone_number": "323-563-9499",
            "fax_number": "323-563-0956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2016-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A94116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A94160",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Gate, CA

Sources for this page

Verify at the official NPI Registry.