Jordan D Dierdorff, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA060095 Issued in PA

Practice address

1251 S Cedar Crest Blvd Ste 202a
Allentown, PA 18103-6214

Phone

(610) 402-5766

Fax

(610) 402-5763

NPI assigned

Oct 17, 2018

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

Other names 1

• Jordan Goodwin Former name

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jgoodwin241981@direct2.lvhn.org

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.

• Lehigh Valley Physician Group

  • Developmental - Behavioral Pediatrics Physician
  • Allentown, PA
  • NPI 1780155689
  Medicare reassignment Care Compare group
• St. Luke'S Physician Group, Inc.

  • Family Medicine Physician
  • Bethlehem, PA
  • NPI 1700984622
  Medicare reassignment
• Lehigh Valley Physician Group

  • Family Medicine Physician
  • Orefield, PA
  • NPI 1023346285
  NPD
• Lehigh Valley Physician Group

  • Family Medicine Physician
  • East Stroudsburg, PA
  • NPI 1245093368
  NPD
• St Luke'S Physician Group Inc

  • Colon & Rectal Surgery Physician
  • Bethlehem, PA
  • NPI 1306563838
  NPD
• St Luke'S Physician Group Inc

  • Family Medicine Physician
  • Orwigsburg, PA
  • NPI 1710845144
  NPD

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

• Lehigh Valley Hospital

  • General Acute Care Hospital
  • Allentown, PA
  • NPI 1164400131
  Care Compare affiliation
• Lehigh Valley Hospital

  • Clinic/Center
  • Allentown, PA
  • NPI 1194673467

  Hospital

  Care Compare affiliation
• Lehigh Valley Hospital

  • Clinic/Center
  • Allentown, PA
  • NPI 1528627155

  Hospital

  Care Compare affiliation
• Lehigh Valley Hospital

  • Psychiatric Hospital Unit
  • Bethlehem, PA
  • NPI 1609834001
  Care Compare affiliation
• Lehigh Valley Hospital

  • Children's Hospital
  • Allentown, PA
  • NPI 1952954307
  Care Compare affiliation

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

{
    "created_epoch": "1539734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1730655796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD FL 4",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035622",
            "telephone_number": "484-884-0688",
            "fax_number": "484-884-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 S CEDAR CREST BLVD STE 202A",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036214",
            "telephone_number": "610-402-5766",
            "fax_number": "610-402-5763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIERDORFF",
        "first_name": "JORDAN",
        "middle_name": "D",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-17",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA060095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "GOODWIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Claire Banico Didulo, PT
• Alexis N Diegel, CRNP
• Michael Eric Diehl, ATC
• Samantha Diehl
• Mina Diep
• Brittany P Dierwechter, PT, DPT
• Jana B. Dieterich, PA-C
• George Difiore
• Christopher T Dileo, DMD
• Joanne M Dileo, O.T.

• Medical Physician Assistant in Allentown, PA
• Providers in Allentown, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.