NPIMap

Individual provider Active NPI

Jordan Vroman, DO

  • Family Medicine Physician
  • Erie, PA
National Provider Identifier
1982271946
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OT020930 Issued in PA
Practice address
5515 Peach St
Erie, PA 16509-2695
Phone
(814) 864-4031
NPI assigned
Jun 8, 2021
Last updated
Jun 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OT020930 PA Primary

Addresses

Primary practice location

5515 Peach St
Erie, PA 16509-2695

Mailing address

4112 Cherry St
Erie, PA 16509-1611
Phone (814) 528-4343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240507003800 PA Practitioner - Family Practice 7416398557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5401 Peach St
Suite 3400
Erie, PA 16509-2601
Phone (814) 868-2200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue60
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OT020930PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Practice of Lecom Institute for Successful Living CurrentSince Jul 1, 2024 Accepting new patients
Clinical Practice of Lecom Institute for Successful Living CurrentSince Jul 1, 2024 Accepting new patients
Clinical Practice of Lecom Institute for Successful Living Family Medicine Past Accepting new patients
Lecom at Village Square, LLC Past Accepting new patients
Clinical Practice of Lecom Institute for Successful Living Past Accepting new patients
Medical Associates of Erie Past Accepting new patients

Locations

149 W 22nd St
Erie, PA 16502
Phone (814) 452-3271

5401 Peach St
Erie, PA 16509
Phone (814) 868-2170

5401 Peach St
Ste 3400
Erie, PA 16509
Phone (814) 868-2200

5535 Peach St
Erie, PA 16509
Phone (814) 868-3488

9040 Wattsburg Rd
Erie, PA 16509
Phone (814) 737-0833

Interoperability endpoints

  • Direct secure messaging: jvroman@lisl.medentdirect.com

Organizations & group practices 6

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1982271946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4112 CHERRY ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165091611",
            "telephone_number": "814-528-4343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5515 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092695",
            "telephone_number": "814-864-4031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VROMAN",
        "first_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-08",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OT020930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.