Individual provider Active NPI

Jordan Richard Stewart, D.P.M

  • Foot & Ankle Surgery Podiatrist
  • Timonium, MD
National Provider Identifier
1689624033
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
01433 Issued in MD
Practice address
9622 Deereco Rd
Timonium, MD 21093-2120
Phone
(410) 560-2777
Fax
(443) 901-1131
NPI assigned
May 10, 2006
Last updated
Jun 23, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 01433 MD Primary

Addresses

Primary practice location

9622 Deereco Rd
Timonium, MD 21093-2120

Mailing address

9622 Deereco Rd
Timonium, MD 21093-2120
Phone (410) 560-2777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060731000051 MD Practitioner - Podiatry 8628081197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9622 Deereco Rd
Timonium, MD 21093-2120
Phone (410) 560-2777

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue76
Removal of skin lesions407
Removal of nail tissue1024
Removal or shaving of skin growth779
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01433MDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jordan R. Stewart, DPM, LLC Foot & Ankle Surgery CurrentSince Jul 14, 2006 Accepting new patients

Locations

9622 Deereco Rd
Timonium, MD 21093
Phone (410) 560-2777

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214179200000",
    "number": "1689624033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9622 DEERECO RD",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210932120",
            "telephone_number": "410-560-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9622 DEERECO RD",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210932120",
            "telephone_number": "410-560-2777",
            "fax_number": "443-901-1131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "JORDAN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.P.M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2008-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MD",
            "license": "01433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Timonium, MD

Sources for this page

Verify at the official NPI Registry.