JORDAN BLAINE
NPI 1093171480
Nurse Practitioner - Psychiatric/Mental Health in Orange, CA

Active since January 14, 2016PECOS EnrolledAccepts Medicare Assignment
4900 E CHAPMAN AVE UNIT 103, ORANGE, CA 92869(323) 365-6312 Get Directions Write a Review

NPPES record last updated: May 6, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 6, 2020, Jan 14, 2016 (2 updates tracked since 2016).

About Jordan Blaine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JORDAN BLAINE (NPI 1093171480) is an individual psychiatric/mental health provider in Orange, California, licensed in California (95014481) and active in the NPI registry since January 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1093171480
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameJORDAN BLAINE
Location Address4900 E CHAPMAN AVE UNIT 103Orange, CA 92869-4140
Mailing Address4900 E Chapman Ave Unit 103Orange, CA 92869-4140 · (323) 365-6312
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateJanuary 14, 2016
Last NPPES UpdateMay 6, 20202 updates tracked since enumeration
NPPES CertifiedMay 6, 2020
✔ NPI 1093171480 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in CA · 95014481
4900 E CHAPMAN AVE UNIT 103, Orange, CA 92869

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jordan Blaine is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9638598113
PECOS Enrollment IDI20201001003510
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Jordan Blaine reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Psychiatry
6226 E SPRING ST STE 375
Long Beach, CA 90815
  • Reassigned Medicare billing, California enrollment
  • 32 clinicians in this Medicare group
Psychiatric/Mental Health
2382 FARADAY AVE STE 100
Carlsbad, CA 92008
  • Reassigned Medicare billing, California enrollment
  • 18 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92869 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jordan Blaine's NPI number?

The NPI number for Jordan Blaine is 1093171480. It was assigned to this individual provider in the NPPES registry on January 14, 2016.

Where is Jordan Blaine located?

Jordan Blaine practices at 4900 E Chapman Ave Unit 103, Orange, CA 92869. The listed phone number is (323) 365-6312.

What is Jordan Blaine's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Jordan Blaine enrolled in Medicare?

Yes. Jordan Blaine is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Jordan Blaine's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jordan Blaine reassigns Medicare benefits to 2 organizations: Thomas Health Services Inc (Long Beach, CA) and Inspire Psychiatric Nursing Services Inc (Carlsbad, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jordan Blaine's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jordan Blaine was last updated on May 6, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.