Individual provider Active NPI

Jordan Blaustein, DC

  • Chiropractor
  • Cape Coral, FL
National Provider Identifier
1659607026
Registry record updated Dec 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH-11542 Issued in FL
Practice address
2717 Santa Barbara Blvd Ste 7
Cape Coral, FL 33914-4432
Phone
(623) 984-9984
Fax
(239) 984-9986
NPI assigned
Oct 20, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH-11542 FL Primary

Addresses

Primary practice location

2717 Santa Barbara Blvd Ste 7
Cape Coral, FL 33914-4432

Mailing address

2717 Santa Barbara Blvd Ste 7
Cape Coral, FL 33914-4432
Phone (239) 984-9984

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150729007943 FL Practitioner - Chiropractic 4183938558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

523 Cape Coral Pkwy E
Cape Coral, FL 33904-8545
Phone (239) 984-9984

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH-11542FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Hybrid Health and Recovery Chiropractor Current Accepting new patients
Blaustein Chiropractic Center LLC Chiropractor CurrentSince Dec 3, 2018 Accepting new patients

Locations

2717 Santa Barbara Blvd
Ste 7
Cape Coral, FL 33914
Phone (239) 984-9984

523 Cape Coral Pkwy E
Cape Coral, FL 33904
Phone (239) 549-2772

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544745600000",
    "number": "1659607026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2717 SANTA BARBARA BLVD STE 7",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339144432",
            "telephone_number": "239-984-9984",
            "fax_number": "239-984-9986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2717 SANTA BARBARA BLVD STE 7",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339144432",
            "telephone_number": "623-984-9984",
            "fax_number": "239-984-9986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAUSTEIN",
        "first_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-20",
        "last_updated": "2018-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH-11542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.