Individual provider Active NPI

Jordan N Stemer - Miranda, PA

  • Medical Physician Assistant
  • Crown Point, IN
National Provider Identifier
1861708323
Registry record updated Feb 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
99043669 Issued in IN
Practice address
70 W 94TH PL
Crown Point, IN 46307
Phone
(219) 662-8822
Fax
(219) 662-8833
NPI assigned
Aug 23, 2010
Last updated
Feb 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 99043669 IN Primary
Surgical Physician Assistant 363AS0400X 99043669 IN

Addresses

Primary practice location

70 W 94TH PL
Crown Point, IN 46307

Mailing address

70 W 94TH PL
Crown Point, IN 46307-1710
Phone (219) 662-8822

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address JS4584@forefrontdermatology.emadirect.md

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100925000340 IN Practitioner - Physician Assistant 5092831156 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

303 S Walnut St
Seymour, IN 47274-2368
Phone (812) 358-7705

70 W 94TH PL
Crown Point, IN 46307-1710
Phone (219) 662-8822

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
91.08 of 100Reported as group
Quality
90
Improvement activities
40
Cost
66.95

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
99043669INMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Forefront Dermatology, S.C. CurrentSince Jan 15, 2019 Accepting new patients
Mitchell Leslie Bressack Current Accepting new patients
Franciscan Medical Specialists Past Accepting new patients
Forefront Dermatology, S.C. Past Accepting new patients
Franciscan Physician Network Past Accepting new patients

Locations

70 W 94th Pl
Crown Point, IN 46307
Phone (219) 662-8822

7516 Eagle Crest Blvd
Ste D
Evansville, IN 47715
Phone (812) 401-8999

303 S Walnut St
Seymour, IN 47274
Phone (812) 358-7705

801 York St
Manitowoc, WI 54220
Phone (866) 630-9882

Interoperability endpoints

  • Direct secure messaging: js4584@forefrontdermatology.emadirect.md

Organizations & group practices 6

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 2

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": "1282521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1861708323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 W 94TH PL",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463071710",
            "telephone_number": "219-662-8822",
            "fax_number": "219-662-8833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 W 94TH PL",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "46307",
            "telephone_number": "219-662-8822",
            "fax_number": "219-662-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEMER - MIRANDA",
        "first_name": "JORDAN",
        "middle_name": "N",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-23",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "99043669",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IN",
            "license": "99043669",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JS4584@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "70 W 94th Pl",
            "city": "Crown Point",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

Verify at the official NPI Registry.