Individual provider Active NPI

Michael T Jordan, PA-C

  • Surgical Physician Assistant
  • Huntsville, AL
National Provider Identifier
1639258494
Registry record updated Feb 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA513 Issued in AL
Practice address
927 Franklin St SE
The Orthopaedic Center
Huntsville, AL 35801-4306
Phone
(256) 539-2728
Fax
(256) 428-3423
NPI assigned
Nov 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA513 AL Primary

Addresses

Primary practice location

927 Franklin St SE
The Orthopaedic Center
Huntsville, AL 35801-4306

Mailing address

927 Franklin St SE
The Orthopaedic Center
Huntsville, AL 35801-4306
Phone (256) 539-2728

Other identifiers 4

IdentifierTypeStateIssuer
51546369OtherALBCBS
7088895OtherALAETNA
009913302MedicaidAL
POO777891OtherALRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20070424000547 AL Practitioner - Physician Assistant 5294648010 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical University of South Carolina College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HH Health System - the Orthopaedic Center LLCGroup PAC ID 0547624843, 172 clinicians

Practice addresses (Care Compare)

927 Franklin St SE
Huntsville, AL 35801-4305
Phone (256) 539-2728

Hospital & facility affiliations

  • Huntsville Hospital Hospital, Huntsville, AL, CCN 010039

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA513ALMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lakelands Orthopaedic Clinic Past Accepting new patients

Organizations & group practices 3

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": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265587200000",
    "number": "1639258494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 FRANKLIN ST SE",
            "address_2": "THE ORTHOPAEDIC CENTER",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014306",
            "telephone_number": "256-539-2728",
            "fax_number": "256-428-3423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 FRANKLIN ST SE",
            "address_2": "THE ORTHOPAEDIC CENTER",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014306",
            "telephone_number": "256-539-2728",
            "fax_number": "256-428-3423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "MICHAEL",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2010-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AL",
            "license": "PA513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51546369",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7088895",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009913302",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "POO777891",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.