Jordan Faulkner, MSPAS, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

57583 Issued in CA

Practice address

2920 Telegraph Ave Ste 100
Berkeley, CA 94705-2031

Phone

(949) 549-5401

NPI assigned

Jan 26, 2017

Last updated

Oct 5, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

91.9 of 100Reported as group

Quality

81.89

Promoting interoperability

99

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Carbon Health Primary Care of California PC

  • Multi-Specialty Clinic/Center
  • Berkeley, CA
  • NPI 1972057990
  NPD (past)

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

{
    "created_epoch": "1485388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1689111759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 TELEGRAPH AVE STE 100",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052031",
            "telephone_number": "510-904-4287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 TELEGRAPH AVE STE 100",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052031",
            "telephone_number": "949-549-5401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Embarcadero Ctr Lbby Level",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941113823",
            "country_code": "US",
            "telephone_number": "888-663-6331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAULKNER",
        "first_name": "JORDAN",
        "name_prefix": "Mrs.",
        "credential": "MSPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-26",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "57583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sage Fanucchi-Funes, CNM
• Farshid Farrahi, M.D.
• Maire Farrington, M.F.T.
• Emily Farwig, L.AC.
• Elayne Marye Faucett-Maples, NP
• Sean Faulkner
• Jennifer Faust, DNP, PMHNP
• Daniel Fazio, M.D.
• Paul Augie Feder, M.A., MFT
• Madeline Licker Feingold, PH.D.

• Physician Assistant in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.