Individual provider Active NPI

Jordan Aney, M.D.

  • Pediatrics Physician
  • Loma Linda, CA
National Provider Identifier
1922419902
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A138278 Issued in CA
Practice address
25845 Barton Rd
Loma Linda, CA 92354-3899
Phone
(909) 558-2828
NPI assigned
May 13, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A138278 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

25845 Barton Rd
Loma Linda, CA 92354-3899

Mailing address

54701 File Number
Los Angeles, CA 90074-4701
Phone (909) 651-4300

Other practice location 1

11234 Anderson St
Loma Linda University Medical Center - Pediatrics
Loma Linda, CA 92354-2804
Phone (909) 558-4174

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, ID2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171023003013 CA Practitioner - Pediatric Medicine 2769758572 Reassigns benefits to 1 organization
I20190208001742 ID Practitioner - Pediatric Medicine 2769758572 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A138278CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC Pediatrics CurrentSince Jan 15, 2019 Accepting new patients
County of San Bernardino CurrentSince Nov 4, 2017 Accepting new patients
County of San Bernardino Current Accepting new patients
St Lukes Clinic-Treasure Valley LLC Pediatrics CurrentSince Jan 15, 2019 Accepting new patients

Locations

303 E Mountain View St
Barstow, CA 92311
Phone (760) 256-4705

351 N Mountain View Ave
Rm 303
Sn Bernrdno, CA 92415

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

Interoperability endpoints

  • Direct secure messaging: janey119691@direct.slhs.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1922419902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54701 FILE NUMBER",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900744701",
            "telephone_number": "909-651-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25845 BARTON RD",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543899",
            "telephone_number": "909-558-2828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11234 Anderson St",
            "address_2": "Loma Linda University Medical Center - Pediatrics",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923542804",
            "country_code": "US",
            "telephone_number": "909-558-4174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANEY",
        "first_name": "JORDAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-13",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A138278",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.