Jordan Brett Graffagnino, LSA, CSFA

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

License

SA00483 Issued in TX

Practice address

9325 Phelan Blvd
Beaumont, TX 77706-5122

Phone

(409) 554-1138

NPI assigned

Aug 2, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Texas Surgical Associates LLC

  • Surgical Assistant
  • Beaumont, TX
  • NPI 1093473183
  NPD Authorized official

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

{
    "created_epoch": "1343865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1689920175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9325 PHELAN BLVD",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777065122",
            "telephone_number": "409-554-1138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9325 PHELAN BLVD",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777065122",
            "telephone_number": "409-554-1138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAFFAGNINO",
        "first_name": "JORDAN",
        "middle_name": "BRETT",
        "name_prefix": "Mr.",
        "credential": "LSA, CSFA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-02",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "SA00483",
            "primary": false
        },
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "TX",
            "license": "136982",
            "primary": false
        },
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "TX",
            "license": "SA00483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace & Mercy Missionary Baptist Church
• Grace Healthcare Staffing Agency
• Connie R Gradney, LBSW
• Dominic Joseph Gradozzi III
• Brianna Lee Graffagnino, LMT
• Lacey N Graffagnino, LSA
• Clancie Calais Grant, RPH
• Shawn Rooney Gray, MSN
• Great American Scooter Company Golden Triangle LLC
• Greater Beaumont Oral & Maxillofacial Surgery, PA

• Surgical Assistant in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Surgical Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; 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.