Individual provider Active NPI

Jordan Elizabeth Krouner Hitchens, D.O.

  • Emergency Medicine Physician
  • Worcester, MA
National Provider Identifier
1659807006
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
286728 Issued in MA
Practice address
55 Lake Ave N
Worcester, MA 01655-0002
Phone
(508) 421-1400
Fax
(508) 421-1490
NPI assigned
May 4, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 286728 MA Primary

Addresses

Primary practice location

55 Lake Ave N
Worcester, MA 01655-0002

Mailing address

PO Box 415348
Boston, MA 02241-5348

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MD, DC, NY4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20220222000865 TX Practitioner - Emergency Medicine 4688075708 Reassigns benefits to 1 organization
I20230301000986 MD Practitioner - Emergency Medicine 4688075708 Reassigns benefits to 2 organizations
I20230321000005 DC Practitioner - Emergency Medicine 4688075708 Reassigns benefits to 1 organization
I20240212003964 NY Practitioner - Emergency Medicine 4688075708 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
286728MAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Ridge Indian Health Service Hospital CurrentSince Jan 24, 2022 Accepting new patients
Chester River Health Center CurrentSince Jan 1, 2023 Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Jan 24, 2022 Accepting new patients
Physician Affiliate Group of New York PC CurrentSince Sep 5, 2024 Accepting new patients
Medstar Medical Group II LLC Emergency Medicine CurrentSince Jun 1, 2025 Accepting new patients
Pine Ridge Indian Health Service Hospital Current Accepting new patients
Coney Island Medical Practice Plan, P.C. CurrentSince Dec 19, 2023 Accepting new patients
Medstar Medical Group II LLC CurrentSince Jun 1, 2025 Accepting new patients
Chester River Hospital Center CurrentSince Jan 1, 2023 Accepting new patients
Medstar Medical Group II LLC Past Accepting new patients
Memn Hospitalists, LLC Emergency Medicine Past Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

29955 Three Notch Rd
Ste 100
Charlotte Hall, MD 20622
Phone (301) 290-5300

100 Brown St
Chestertown, MD 21620
Phone (410) 778-3300

1406 Crain Hwy S
Ste 106
Glen Burnie, MD 21061
Phone (410) 768-6440

18101 Prince Philip Dr
Olney, MD 20832
Phone (301) 774-8618

2601 Ocean Pkwy
Rm 3N17
Brooklyn, NY 11235
Phone (718) 616-4554

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: jhitchens3751604@nychhc.direct-ci.com

Organizations & group practices 11

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": "1493856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1659807006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-421-1400",
            "fax_number": "508-421-1490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HITCHENS",
        "first_name": "JORDAN",
        "middle_name": "ELIZABETH KROUNER",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-04",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "286728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.