Individual provider Active NPI

Jordan R Conger, M.D.

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1861925026
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X
License
A159379 Issued in CA
Practice address
1450 San Pablo St FL 4
Los Angeles, CA 90033-5331
Phone
(323) 442-6335
NPI assigned
Apr 5, 2017
Last updated
Jun 29, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 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
Ophthalmology Physician 207W00000X A159379 CA
Ophthalmic Plastic and Reconstructive Surgery Physician 207WX0200X A159379 CA Primary

Addresses

Primary practice location

1450 San Pablo St FL 4
Los Angeles, CA 90033-5331

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (626) 457-6601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20210525000301 CA Practitioner - Ophthalmology 6406189661 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Virginia School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
EyestheticaGroup PAC ID 2668553371, 6 clinicians

Practice addresses (Care Compare)

16055 Ventura Blvd
Suite 750
Encino, CA 91436-2610
Phone (213) 234-1000

2121 Wilshire Blvd
Suite 301
Santa Monica, CA 90403-5743
Phone (310) 299-8865

50 Central CT
Pasadena, CA 91105-2060
Phone (626) 662-7758

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A159379CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Jun 1, 2022 Accepting new patients
Usc Care Medical Group, Inc Ophthalmology CurrentSince Jun 1, 2022 Accepting new patients
Southern California Healthcare System, Inc Past Accepting new patients
Dignity Community Care Past Accepting new patients
Cha Medical and Surgical Group, PC Ophthalmology Past Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

1450 San Pablo St
Fl 4
Los Angeles, CA 90033
Phone (323) 442-6335

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5860

625 S Fair Oaks Ave
Ste 265
Pasadena, CA 91105
Phone (626) 564-0004

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/imedicware_chamg
  • FHIR API: https://fhir-myrecord.cerner.com/r4/ZovcCzFH9WoaIYAtfnADtCEJJqhJ7vbO/
  • Direct secure messaging: jordan.conger.p1@direct.eyesthetica.nextgenshare.com

Organizations & group practices 7

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 3

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": "1491350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1861925026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "626-457-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 SAN PABLO ST FL 4",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335331",
            "telephone_number": "323-442-6335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONGER",
        "first_name": "JORDAN",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-05",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A159379",
            "primary": false
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A159379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.