Mirlande P. Jordan, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

204760 Issued in NY

Practice address

61 Emerald PL
Rock Hill, NY 12775-6049

Phone

(845) 703-6999

Fax

(845) 703-6297

NPI assigned

Nov 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

State University of Ny Upstate Medical University, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Crystal Run Healthcare Physicians LLPGroup PAC ID 6901792696, 366 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mjordan220140@direct.optum.com

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.

• Crystal Run Healthcare Physicians LLP

  • General Practice Physician
  • Middletown, NY
  • NPI 1952376410
  Medicare reassignment Care Compare group NPD
• Crystal Run Healthcare Physicians LLP

  • Durable Medical Equipment & Medical Supplies
  • Monroe, NY
  • NPI 1558857425
  NPD

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1962575753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 411730",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022411730",
            "telephone_number": "845-703-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 EMERALD PL",
            "city": "ROCK HILL",
            "state": "NY",
            "postal_code": "127756049",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "43 Ashley Ave",
            "address_2": "Building 57",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "NY",
            "postal_code": "10940",
            "country_code": "US",
            "telephone_number": "845-343-6686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "MIRLANDE",
        "middle_name": "P.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "204760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kate M. Ingber, PA-C
• Jadd Pharmacy Corp
• Syed Z Jafri, M.D.
• Todd P Jessup, M.D.
• Sindhu John
• Rajan S Karuvelankulam Subbiah, M.D
• Rebecca Kegler
• Allison Lynae Kouloumbinis, FNP
• Melissa Coll Kubenik, M.D.
• Florence Lazaroff

• Psychiatry Physician in Rock Hill, NY
• Providers in Rock Hill, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2025; 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.

Verify at the official NPI Registry.