NPIMap

Individual provider Active NPI

Jordan Ernst, DPM, MS

  • Foot & Ankle Surgery Podiatrist
  • Grapevine, TX
National Provider Identifier
1801281779
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO3988 Issued in FL
Practice address
1600 W College St Ste 100
Grapevine, TX 76051-3575
Phone
(817) 421-0505
Fax
(817) 421-6060
NPI assigned
Mar 30, 2015
Last updated
Jan 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Foot & Ankle Surgery Podiatrist 213ES0103X 3012 TX
Foot & Ankle Surgery Podiatrist 213ES0103X PO3988 FL Primary

Addresses

Primary practice location

1600 W College St Ste 100
Grapevine, TX 76051-3575

Mailing address

3155 Stars and Stripes Way Apt 471
Grapevine, TX 76051-1520
Phone (402) 881-1522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181116000938 FL Practitioner - Podiatry 3971857509 Reassigns benefits to 1 organization
I20200330001897 TX Practitioner - Podiatry 3971857509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monument Health Rapid City Hospital IncGroup PAC ID 6002729506, shared by 4 NPIs, 560 clinicians

Practice addresses (Care Compare)

2929 5TH St
Rapid City, SD 57701-7363
Phone (605) 755-1309

353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone (605) 755-8109

815 Ira E Woods Ave
Suite 100
Grapevine, TX 76051-4009
Phone (817) 421-0505

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue89
Removal of nail tissue56
Removal or shaving of skin growth19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Institute of Orthopedic Surgery & Sports Medicine PLLC Multi-Specialty CurrentSince Apr 1, 2020 Accepting new patients
Tenet Florida Physician Services II, LLC Multi-Specialty CurrentSince Aug 1, 2018 Accepting new patients
Tenet Florida Physician Services II, LLC Multi-Specialty CurrentSince Aug 1, 2018 Accepting new patients

Locations

9960 Central Park Blvd N
Ste 400
Boca Raton, FL 33428
Phone (561) 470-5437

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

1000 NE 56th St
Oakland Park, FL 33334
Phone (954) 229-8608

815 Ira E Woods Ave
Ste 100
Grapevine, TX 76051
Phone (817) 421-0505

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FIDCCD

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 6

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": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1801281779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3155 STARS AND STRIPES WAY APT 471",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760511520",
            "telephone_number": "402-881-1522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W COLLEGE ST STE 100",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513575",
            "telephone_number": "817-421-0505",
            "fax_number": "817-421-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERNST",
        "first_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "DPM, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-30",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "3012",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO3988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grapevine, TX

Sources for this page

Verify at the official NPI Registry.