Jordan Lane Lass, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9118385 Issued in FL

Practice address

500 Winderley PL Ste 115
Maitland, FL 32751-7406

Phone

(407) 875-0555

NPI assigned

Jan 15, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Florida Emergency Physicians Kang and Associates MD LLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Orlando, FL
  • NPI 1811983752
  Medicare reassignment
• Observation Medicine Specialists LLC

  • Internal Medicine Physician
  • Maitland, FL
  • NPI 1134596893
  NPD (past)

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

{
    "created_epoch": "1705276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1730950163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2259 BANCROFT BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328333804",
            "telephone_number": "561-512-6749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WINDERLEY PL STE 115",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517406",
            "telephone_number": "407-875-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASS",
        "first_name": "JORDAN",
        "middle_name": "LANE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-15",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9118385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy W Langerholc, LMHC
• Donna Lynn Lapalm, MHC RI
• Anthony L. Laporte, CRNA
• Irene Lardizabal, PT
• Juan Manuel Lares Perez
• Kimberly Contigiani Lauer, CRNA
• Shauna M Laughna, PH.D., ABPP
• Rala Lauser
• Erika J Lawrence, RCSWI
• Sharon Lawrence

• Physician Assistant in Maitland, FL
• Providers in Maitland, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.