Individual provider Active NPI

Jordan Michael Virbalas

  • Otolaryngology Physician
  • Bronx, NY
National Provider Identifier
1700103041
Registry record updated Jul 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
AB1876296 Issued in NY
Practice address
3400 Bainbridge Ave
Dept of Otolaryngology, 3Rd Floor
Bronx, NY 10467-2404
Phone
(617) 501-0198
NPI assigned
Apr 27, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X AB1876296 NY Primary

Addresses

Primary practice location

3400 Bainbridge Ave
Dept of Otolaryngology, 3Rd Floor
Bronx, NY 10467-2404

Mailing address

536 Bergen St
Apt 3R
Brooklyn, NY 11217-4001
Phone (617) 501-0198

Other names 1

  • Jordan Michael Virball Former name

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160630001620 CA Practitioner - Otolaryngology 7214257567 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.01 of 100Reported as group
Quality
86.78
Improvement activities
40
Cost
70.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AB1876296NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco CurrentSince Jul 1, 2016 Accepting new patients
University of California SFGH Medical Group CurrentSince Jun 5, 2016 Accepting new patients
University of California San Francisco Current Accepting new patients
UCSF Medical Group Business Services Otolaryngology CurrentSince Jul 1, 2016 Accepting new patients
University of California San Francisco CurrentSince Jul 1, 2016 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jul 1, 2016 Accepting new patients
University of California SFGH Medical Group Otolaryngology CurrentSince Jun 5, 2016 Accepting new patients
University of California San Francisco Past Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients

Locations

1001 Potrero Ave
Rm 3A32
San Francisco, CA 94110
Phone (628) 206-8291

400 Parnassus Ave
#300
San Francisco, CA 94143
Phone (415) 476-2163

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

400 Parnassus Ave
San Francisco, CA 94143
Phone (415) 353-2000

3333 California St
Ste S110
San Francisco, CA 94118

2380 Sutter St
San Francisco, CA 94115
Phone (415) 353-2757

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

Interoperability endpoints

  • Direct secure messaging: jvirbalas80983@direct-ucsfmedicalcenter.org

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1272326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279756800000",
    "number": "1700103041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "536 BERGEN ST",
            "address_2": "APT 3R",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112174001",
            "telephone_number": "617-501-0198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 BAINBRIDGE AVE",
            "address_2": "DEPT OF OTOLARYNGOLOGY, 3RD FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672404",
            "telephone_number": "617-501-0198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIRBALAS",
        "first_name": "JORDAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-27",
        "last_updated": "2010-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "AB1876296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "VIRBALL",
            "middle_name": "MICHAEL",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.