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JORDAN ROSE
NPI 1164095964
Nurse Practitioner - Psychiatric/Mental Health in Santa Rosa, CA

Active since July 20, 2021PECOS Enrolled
1287 FULTON RD, SANTA ROSA, CA 95401(707) 800-7700 Get Directions Write a Review

NPPES record last updated: June 26, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 26, 2024, Jul 20, 2021 (2 updates tracked since 2021).

About Jordan Rose NPPES

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

JORDAN ROSE (NPI 1164095964) is an individual psychiatric/mental health provider in Santa Rosa, California, licensed in California (95025794) and active in the NPI registry since July 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1164095964
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameJORDAN ROSE
Location Address1287 FULTON RDSanta Rosa, CA 95401-4923
Mailing AddressPo Box 464Mill Valley, CA 94942-0464 · (707) 800-7700
Phone(707) 800-7700
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateJuly 20, 2021
Last NPPES UpdateJune 26, 20242 updates tracked since enumeration
NPPES CertifiedJune 26, 2024
✔ NPI 1164095964 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in CA · 95025794
Also ListedRegistered NurseTaxonomy 163W00000X · License 95224646 (CA)
1287 FULTON RD, Santa Rosa, CA 95401
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jordan Rose is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5991237042
PECOS Enrollment IDI20241015001942
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95401 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
$96.16 typical visit price
range $63.04 – $187.01
Typical copayment $24.04 (range $15.76 – $46.75)
Most-billed visit code 99203
Established Patient
$109.88 typical visit price
range $21.02 – $153.40
Typical copayment $27.47 (range $5.25 – $38.35)
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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TRADITIONS PSYCHIATRY GROUP, P.C
Psychiatry & Neurology (Psychiatry)
1287 FULTON RD
SANTA ROSA, CA 95401
Sonoma County (707) 258-8757
ROBERT ALLEN KAYSER MD
Specialist
1287 FULTON RD
SANTA ROSA, CA 95401
Sonoma County (707) 543-2440
NAKISA KIA'I MD
Psychiatry & Neurology (Psychiatry)
1287 FULTON RD
SANTA ROSA, CA 95401
Sonoma County (707) 800-7700
CENTER FOR DIAGNOSTIC AND INTERVENTIONAL PSYCHIATRY
Psychiatry & Neurology (Psychiatry)
1287 FULTON RD
SANTA ROSA, CA 95401
Sonoma County (707) 800-7716
MICHAEL L. MEDVIN M.D.
Emergency Medicine
1287 FULTON RD
SANTA ROSA, CA 95401
Sonoma County (707) 888-5808
ROSE HATHAWAY DAKIN RN
Student in an Organized Health Care Education/Training Program
1287 FULTON RD
SANTA ROSA, CA 95401
Sonoma County (707) 800-7700
PATRICIA K STAGG M.D.
Emergency Medicine
1287 FULTON RD, ST JOSEPH'S URGENT CARE - FULTON CAMPUS
SANTA ROSA, CA 95401
Sonoma County (707) 543-2000
JON STERNGOLD MD
General Practice
1287 FULTON RD
SANTA ROSA, CA 95401
Sonoma County (707) 595-3133

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 Rose's NPI number?

The NPI number for Jordan Rose is 1164095964. It was assigned to this individual provider in the NPPES registry on July 20, 2021.

Where is Jordan Rose located?

Jordan Rose practices at 1287 Fulton Rd, Santa Rosa, CA 95401. The listed phone number is (707) 800-7700.

What is Jordan Rose's specialty?

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

Is Jordan Rose enrolled in Medicare?

Yes. Jordan Rose is registered in the Medicare PECOS enrollment system.

What insurance does Jordan Rose accept?

Health plans from Providence Health Plan list Jordan Rose as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jordan Rose was last updated on June 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.