NPIMap

Individual provider Active NPI

Jacquelyn B Jordan, MD

  • Internal Medicine Physician
  • Buffalo, NY
National Provider Identifier
1780180133
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
318282-01 Issued in NY
Practice address
325 Essjay Rd
Buffalo, NY 14221-8243
Phone
(716) 656-4484
Fax
(716) 817-1740
NPI assigned
Apr 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 318282-01 NY Primary

Addresses

Primary practice location

325 Essjay Rd
Buffalo, NY 14221-8243

Mailing address

425 Essjay Rd Ste 170
Buffalo, NY 14221-8235
Phone (716) 630-1219

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address production@direct.buffalomedicalgroup.com Buffalo Medical Group, P.C.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220829001192 NY Practitioner - Internal Medicine 2668711649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
State University of New York at Buffalo School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Buffalo Medical Group, P.C.Group PAC ID 7012820301, 233 clinicians

Practice addresses (Care Compare)

3900 N Buffalo St
Orchard Park, NY 14127-1842
Phone (716) 630-1000

Hospital & facility affiliations

  • Vna of Western Ny Chha Home health agency, Cheektowaga, NY, CCN 337006
  • Mount St. Mary'S Hospital & Health Center Hospital, Lewiston, NY, CCN 330188
  • Kaleida Health Hospital, Buffalo, NY, CCN 330005
  • Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
318282-01NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Buffalo Medical Group, P.C. Internal Medicine CurrentSince Aug 15, 2022 Accepting new patients
Buffalo Medical Group, P.C. CurrentSince Aug 15, 2022 Accepting new patients

Locations

85 High St
Buffalo, NY 14203
Phone (716) 857-8623

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

6950 S Transit Rd
Lockport, NY 14094
Phone (716) 630-1322

3900 N Buffalo St
Orchard Park, NY 14127
Phone (716) 630-1112

425 Essjay Rd
Ste 170
Williamsville, NY 14221
Phone (716) 630-1219

325 Essjay Rd
Williamsville, NY 14221
Phone (716) 630-1102

Interoperability endpoints

  • Direct secure messaging: jjordan14483@direct.buffalomedicalgroup.com
  • Direct secure messaging: production@direct.buffalomedicalgroup.com

Organizations & group practices 2

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.

Hospital & facility affiliations 10

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": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1780180133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 ESSJAY RD STE 170",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142218235",
            "telephone_number": "716-630-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 ESSJAY RD",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142218243",
            "telephone_number": "716-656-4484",
            "fax_number": "716-817-1740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "JACQUELYN",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-04",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "318282-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "production@direct.buffalomedicalgroup.com",
            "affiliation": "Y",
            "affiliationName": "Buffalo Medical Group, P.C.",
            "address_1": "325 Essjay Rd",
            "city": "Buffalo",
            "state": "NY",
            "country_code": "US",
            "postal_code": "142218243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.