Active NPI
Jordan M Tymeson
- Family Nurse Practitioner
- Albany, NY
National Provider Identifier
1942071923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F352802-01
- Practice address
- 62 Hackett Blvd
Albany, NY 12209-1756 - Phone
- (518) 434-2244
- NPI assigned
- Jan 10, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F352802-01 | NY | Primary |
Addresses
Primary practice location
62 Hackett Blvd
Albany, NY 12209-1756
Mailing address
1178 Ardsley Rd
Schenectady, NY 12308-2607
Phone (518) 935-5734
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240214000296 | NY | Practitioner - Nurse Practitioner | 0941644371 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- New York Nephrology and Dialysis Access Surgery, P.C.
Practice addresses (Care Compare)
62 Hackett Blvd
Albany, NY 12209-1756
Phone (518) 434-2244
Hospital & facility affiliations
- St Peter'S Hospital
- Samaritan Hospital of Troy, New York
- Columbia Memorial Hospital
- Ellis Hospital
- Albany Medical Center Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F352802-01 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York Nephrology and Dialysis Access Surgery, P.C. | Current | Accepting new patients |
Locations
62 Hackett Blvd
Albany, NY 12209
Phone (518) 434-2244
Interoperability endpoints
- jtymeson@nenephrology.medentdirect.com
Organizations & group practices 1
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.
-
- Nephrology Physician
- Albany, NY
- NPI 1558338806
NY
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Ambulatory Surgical Clinic/Center
- Niskayana, NY
- NPI 1154973071
Hospital
-
- General Acute Care Hospital
- Albany, NY
- NPI 1497701106
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704844800000",
"number": "1942071923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1178 ARDSLEY RD",
"city": "SCHENECTADY",
"state": "NY",
"postal_code": "123082607",
"telephone_number": "518-935-5734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "62 HACKETT BLVD",
"city": "ALBANY",
"state": "NY",
"postal_code": "122091756",
"telephone_number": "518-434-2244"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYMESON",
"first_name": "JORDAN",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-10",
"last_updated": "2024-01-10",
"certification_date": "2024-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "F352802-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albany, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; 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.