Jorge Fernandez Decordova, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

01045112A Issued in IN

Practice address

901 Macarthur
Munster, IN 46321-2901

Phone

(219) 836-4622

NPI assigned

Sep 19, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pathology

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Indiana Pathology Consultants, P.C.Group PAC ID 0446243943, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Hospital Hospital, Munster, IN, CCN 150125
• St Mary Medical Center Inc Hospital, Hobart, IN, CCN 150034

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Northwest Indiana Pathology Consultants PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Munster, IN
  • NPI 1669459632
  Medicare reassignment Care Compare group NPD
• Goshen Hospital Association Inc

  • General Acute Care Hospital
  • Goshen, IN
  • NPI 1740268846
  Medicare reassignment NPD

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

• Munster Medical Research Foundation Inc

  • General Acute Care Hospital
  • Munster, IN
  • NPI 1003918210
  Care Compare affiliation
• St Mary Medical Center Inc

  • General Acute Care Hospital
  • Hobart, IN
  • NPI 1558463745
  Care Compare affiliation
• St Mary Medical Center Inc

  • General Acute Care Hospital
  • Hobart, IN
  • NPI 1962504175
  Care Compare affiliation

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355702400000",
    "number": "1861487670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10805",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464100805",
            "telephone_number": "800-288-8325",
            "fax_number": "419-866-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 MACARTHUR",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212901",
            "telephone_number": "219-836-4622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ DECORDOVA",
        "first_name": "JORGE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2012-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IN",
            "license": "01045112A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200131350",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ahmad Fathi, MD
• Telisa Amber Fears-Fason, MS, LMFT
• Don Joseph Feeney Jr., PH.D.
• Lois Jayne Felton, RN, CDCES
• Amanda Ferber, NP
• Haley Marie Ferrell
• Deja M Fields
• Seneca Fikes, RBT
• Jazmin Finigan
• Joseph Fink, PH.D.

• Anatomic Pathology & Clinical Pathology Physician in Munster, IN
• Providers in Munster, IN by specialty
• Anatomic Pathology & Clinical Pathology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2012; 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.