Juan A Cordero Jr., MD

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

MD00047531 Issued in WA

Practice address

1100 Goethals Dr
3Rd Floor
Richland, WA 99352-3304

Phone

(509) 942-3095

Fax

(509) 942-3097

NPI assigned

Aug 15, 2005

Last updated

May 10, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Cardiac Surgery

Education

Temple University School of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kadlec Regional Medical CenterGroup PAC ID 9739098617, 402 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kadlec Regional Medical Center Hospital, Richland, WA, CCN 500058

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15298/brand/1/csg/1/fhir/r4
• Direct secure messaging: jcordero1107112@wm.providencedirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kadlec Regional Medical Center

  • General Acute Care Hospital
  • Richland, WA
  • NPI 1972507580
  Medicare reassignment Care Compare group NPD
• Kadlec Regional Medical Center

  dba Kadlec Regional Medical Center - Express Care

  • Clinic/Center
  • Kennewick, WA
  • NPI 1063967933
  NPD
• Kadlec Regional Medical Center

  dba Kadlec Regional Medical Center - Rehab Unit

  • Rehabilitation Hospital Unit
  • Richland, WA
  • NPI 1790319580
  NPD
• Cardiothoracic Surgery Associates PC

  • Vascular Surgery Physician
  • Richland, WA
  • NPI 1881756054
  NPD (past)
• Albany Cardiothoracic Surgeons

  • Specialist
  • Albany, NY
  • NPI 1033159975
  NPD (past)
• St. Peter's Health Partners Medical Associates, P.C.

  • Pediatrics Physician
  • Slingerlands, NY
  • NPI 1669717260
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kadlec Regional Medical Center

  • General Acute Care Hospital
  • Richland, WA
  • NPI 1972507580
  Care Compare affiliation

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1669474151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 S ZINTEL WAY",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993375092",
            "telephone_number": "509-942-3627",
            "fax_number": "509-942-2268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 GOETHALS DR",
            "address_2": "3RD FLOOR",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993523304",
            "telephone_number": "509-942-3095",
            "fax_number": "509-942-3097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDERO",
        "first_name": "JUAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "WA",
            "license": "MD00047531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jcordero1107112@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1100 Goethals Dr",
            "address_2": "3rd Floor",
            "city": "Richland",
            "state": "WA",
            "country_code": "US",
            "postal_code": "993523304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nicole Cooper, PA-C
• Alison Cope, RN
• Mary Christine Cope, FNP
• Sandra Carol Cope, PT
• Kallee Corbin
• Lily Ann Rosete Corleto, ARNP
• Cornerstone Chiropractic Clinic PS
• Costco Wholesale Corporation (Costco Pharmacy #1718)
• Costco Wholesale Corporation (Costco Optical #1718)
• Costco Wholesale Corporation (Costco Hearing Aid #1718)

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Richland, WA
• Providers in Richland, WA by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; 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.