Individual provider Active NPI

Mykala Jordan

  • Surgical Physician Assistant
  • San Diego, CA
National Provider Identifier
1710650940
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA63739 Issued in CA
Practice address
6655 Alvarado Rd
San Diego, CA 92120-5208
Phone
(800) 926-5273
NPI assigned
Jul 25, 2021
Last updated
Nov 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.008678 IL
Surgical Physician Assistant 363AS0400X PA63739 CA Primary

Addresses

Primary practice location

6655 Alvarado Rd
San Diego, CA 92120-5208

Mailing address

File 57326
Los Angeles, CA 90074-7326
Phone (800) 926-8273

Other practice location 1

10 Martin Ave Ste 225
Naperville, IL 60540-6590
Phone (630) 355-5633

Other practice location 2

1N463 Ingalton Ave
West Chicago, IL 60185-2022
Phone (619) 922-9693

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220103000065 IL Practitioner - Physician Assistant 0143611061 Reassigns benefits to 2 organizations
I20251205002017 CA Practitioner - Physician Assistant 0143611061 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6655 Alvarado Rd
San Diego, CA 92120-5208
Phone (858) 249-6753

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
63739CAMDPharmacist
085.008678ILMDPhysician Assistant
PA63739CAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc Multi-Specialty CurrentSince Dec 7, 2025 Accepting new patients
Endeavor Health Medical Group Multi-Specialty CurrentSince Nov 30, 2023 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Multi-Specialty CurrentSince Dec 7, 2025 Accepting new patients
Regents of the University of California Multi-Specialty Current Accepting new patients
Regents of the University of California Multi-Specialty CurrentSince Oct 21, 2025 Accepting new patients
Regents of the University of California Multi-Specialty CurrentSince Oct 21, 2025 Accepting new patients
Edward Health Ventures CurrentSince Jan 10, 2022 Accepting new patients
Edward Health Ventures Multi-Specialty CurrentSince Jan 10, 2022 Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Multi-Specialty Past Accepting new patients

Locations

File 57326
Los Angeles, CA 90074

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5720

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

6655 Alvarado Rd
San Diego, CA 92120
Phone (619) 229-3130

8010 Frost St
Fl 2
San Diego, CA 92123
Phone (800) 827-4277

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

10 Martin Ave
Ste 225
Naperville, IL 60540
Phone (630) 284-9118

120 Spalding Dr
Ste 101
Naperville, IL 60540
Phone (630) 527-7730

120 Spalding Dr
Ste 310
Naperville, IL 60540
Phone (630) 527-5575

Organizations & group practices 10

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1627171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1710650940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE 57326",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900747326",
            "telephone_number": "800-926-8273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6655 ALVARADO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205208",
            "telephone_number": "800-926-5273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Martin Ave Ste 225",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "605406590",
            "country_code": "US",
            "telephone_number": "630-355-5633",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1N463 Ingalton Ave",
            "address_purpose": "LOCATION",
            "city": "West Chicago",
            "state": "IL",
            "postal_code": "601852022",
            "country_code": "US",
            "telephone_number": "619-922-9693",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "MYKALA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-25",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.008678",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA63739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.