KAITLYN JORDAN PA-C
NPI 1497493894
Physician Assistant - Surgical in Bronx, NY

Q: What is Kaitlyn Jordan's NPI number?

The NPI number for Kaitlyn Jordan is 1497493894. It was assigned to this individual provider in the NPPES registry on May 25, 2022.

Q: What is Kaitlyn Jordan's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Kaitlyn Jordan was last updated on May 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since May 25, 2022PECOS Enrolled

111 E 210TH ST, BRONX, NY 10467(718) 920-8874(718) 231-7113 Get Directions Write a Review

NPPES record last updated: May 25, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Kaitlyn Jordan Pa-c NPPES

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

KAITLYN JORDAN PA-C (NPI 1497493894) is an individual surgical provider in Bronx, New York and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS and maintains a secondary practice location in Bronx.

NPPES Registry Identity

NPI1497493894

Entity TypeIndividualFemale

Primary Taxonomy363AS0400X

Provider Legal NameKAITLYN JORDANCredential: PA-C

Location Address111 E 210TH STBronx, NY 10467-2401

Mailing Address111 E 210th StBronx, NY 10467-2401 · (718) 920-8874 · Fax (718) 231-7113

Phone(718) 920-8874

Fax(718) 231-7113

Sole ProprietorNo

Enumeration DateMay 25, 2022

NPPES CertifiedMay 25, 2022

✔ NPI 1497493894 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

111 E 210TH ST, Bronx, NY 10467

Open in Google Maps ↗

Secondary Practice Location 1

Location 11825 Eastchester RdBronx, NY 10461-2301 · Phone (718) 405-8375 · Fax (718) 405-8253

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kaitlyn Jordan Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

DR. MADHU SHARMA MD

Pediatrics (Pediatric Cardiology)

111 E 210TH ST, MONTEFIORE MEDICAL CENTER
BRONX, NY 10467

Bronx County (718) 741-2538

DR. AMANDA MCNEAR JACOBS M.D.

Pediatrics (Adolescent Medicine)

111 E 210TH ST, DEPARTMENT OF PEDIATRICS
BRONX, NY 10467

Bronx County (718) 920-2306

HEATHER ROOT MD

Internal Medicine (Infectious Disease)