Michelle Lynne Jordan, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9104461 Issued in FL

Practice address

11601 Sheldon Rd
Tampa, FL 33626-4306

Phone

(813) 324-6630

Fax

(813) 926-1500

NPI assigned

Mar 6, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Palm Harbor Dermatology PAGroup PAC ID 4789758558, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: mjordan@dmp.emadirect.md

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.

• Palm Harbor Dermatology PA

  • Dermatology Physician
  • Palm Harbor, FL
  • NPI 1497927016
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1649440520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4919 MEMORIAL HWY STE 150",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336347516",
            "telephone_number": "813-333-1528",
            "fax_number": "813-255-2818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11601 SHELDON RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336264306",
            "telephone_number": "813-324-6630",
            "fax_number": "813-926-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "MICHELLE",
        "middle_name": "LYNNE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-06",
        "last_updated": "2022-08-29",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9104461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107119000",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mjordan@dmp.emadirect.md",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11601 Sheldon Rd",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336264306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jessica Joan Jordan
• Jobeth Jordan
• Josephine Jordan, RBT
• Matthew Jordan, MD
• Meghan Lee Jordan, APRN
• Peggy Jordan, MS, CCC-SLP
• Shannon M. Jordan
• Yashica Jordan
• Sarma Jordans, PSYD
• Craig Jorden Jr.

• Medical Physician Assistant in Tampa, FL
• Providers in Tampa, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; 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.