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

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

Other identifiers 3

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

State licenses

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 and National Provider Directory roles.

• Kadlec Regional Medical Center

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

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

  • 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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0237446",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02597148",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8478687",
            "state": "WA"
        }
    ],
    "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 Wholesale Corporation
• Costco Wholesale Corporation

• 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.