Individual provider Active NPI

Jairo Cordero, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Yonkers, NY
National Provider Identifier
1730691221
Registry record updated Oct 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
402200 Issued in NY
Practice address
2 Park Ave
Yonkers, NY 10703-3402
Phone
(914) 964-4362
NPI assigned
Oct 25, 2017
Last updated
Oct 25, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 402200 NY Primary

Addresses

Primary practice location

2 Park Ave
Yonkers, NY 10703-3402

Mailing address

PO Box 998
Yonkers, NY 10703-0998
Phone (914) 966-9787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20190104002538 NY Practitioner - Nurse Practitioner 7911243399 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dobbs Ferry Emergency Medicine, PCGroup PAC ID 8022908268, 39 clinicians

Practice addresses (Care Compare)

128 Ashford Ave
Dobbs Ferry, NY 10522-1924
Phone (914) 964-4370

2 Park Ave
Yonkers, NY 10703-3402
Phone (914) 964-4370

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
402200NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Symphony Medical PC CurrentSince Jan 1, 2019 Accepting new patients
Dobbs Ferry Emergency Medicine, PC CurrentSince Dec 13, 2022 Accepting new patients
Symphony Medical PC CurrentSince Jan 1, 2019 Accepting new patients

Locations

128 Ashford Ave
Dobbs Ferry, NY 10522
Phone (914) 245-8936

2 Park Ave
Yonkers, NY 10703
Phone (914) 964-7723

967 N Broadway
Yonkers, NY 10701
Phone (914) 798-8956

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23390/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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 1

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": "1508889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508889600000",
    "number": "1730691221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 998",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107030998",
            "telephone_number": "914-966-9787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PARK AVE",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107033402",
            "telephone_number": "914-964-4362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDERO",
        "first_name": "JAIRO",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-25",
        "last_updated": "2017-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

Verify at the official NPI Registry.