Individual provider Active NPI

Jordan Vanlare, M.D.

  • General Practice Physician
  • New Rochelle, NY
National Provider Identifier
1669818951
Registry record updated Aug 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
276892 Issued in NY
Practice address
460 Beechmont Dr
New Rochelle, NY 10804-4613
Phone
(914) 200-3782
NPI assigned
May 14, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 276892 NY Primary

Addresses

Primary practice location

460 Beechmont Dr
New Rochelle, NY 10804-4613

Mailing address

460 Beechmont Dr
New Rochelle, NY 10804-4613
Phone (914) 200-3782

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
276892NYMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1368489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439424000000",
    "number": "1669818951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 BEECHMONT DR",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108044613",
            "telephone_number": "914-200-3782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 BEECHMONT DR",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108044613",
            "telephone_number": "914-200-3782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANLARE",
        "first_name": "JORDAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-14",
        "last_updated": "2015-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "276892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Rochelle, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.