Individual provider Active NPI

Jordan Dourmashkin, P.A.

  • Medical Physician Assistant
  • Yonkers, NY
National Provider Identifier
1942224993
Registry record updated Feb 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
008492 Issued in NY
Practice address
56 Arthur PL
Yonkers, NY 10701-1703
Phone
(914) 376-9554
Fax
(914) 376-9554
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 001590 CT
Medical Physician Assistant 363AM0700X 008492 NY Primary
Surgical Physician Assistant 363AS0400X 008492 NY

Addresses

Primary practice location

56 Arthur PL
Yonkers, NY 10701-1703

Mailing address

56 Arthur PL
Yonkers, NY 10701-1703
Phone (914) 376-9554

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041018000408 NY Practitioner - Physician Assistant 3779565296 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001590CTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Oct 9, 2013 Accepting new patients
New York University CurrentSince Oct 9, 2013 Accepting new patients
Westchester Vascular PLLC Past Accepting new patients
Westchester Endrocrinology PLLC Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

600 E 233rd St
Bronx, NY 10466
Phone (718) 920-1640

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Organizations & group practices 8

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265241600000",
    "number": "1942224993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 ARTHUR PL",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011703",
            "telephone_number": "914-376-9554",
            "fax_number": "914-376-9554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 ARTHUR PL",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011703",
            "telephone_number": "914-376-9554",
            "fax_number": "914-376-9554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOURMASHKIN",
        "first_name": "JORDAN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2010-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "001590",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "008492",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "008492",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

Verify at the official NPI Registry.