JORDAN ROSE
NPI 1538768114
Physician Assistant - Surgical in Lackland Afb, TX
About Jordan Rose NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JORDAN ROSE (NPI 1538768114) is an individual surgical provider in Lackland Afb, Texas and active in the NPI registry since October 2020. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
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).
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.
JBSA LACKLAND, TX 78236
JBSA LACKLAND, TX 78236
LACKLAND AFB, TX 78236
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 1538768114. It was assigned to this individual provider in the NPPES registry on October 23, 2020.
Where is Jordan Rose located?
Jordan Rose practices at 1100 Wilford Hall Loop, Lackland Afb, TX 78236. The listed phone number is (210) 292-4897.
What is Jordan Rose's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.
Is Jordan Rose enrolled in Medicare?
Yes. Jordan Rose is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Jordan Rose was last updated on July 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.
# Jordan Rose · NPI 1538768114
Surgical physician in Lackland Afb, Texas. Individual provider, active in the CMS NPPES registry since October 23, 2020.
## Identity
- **NPI:** 1538768114 (Entity type: Individual)
- **Enumerated:** October 23, 2020
- **Primary specialty:** Physician Assistant - Surgical · taxonomy 363AS0400X
- **Sole proprietor:** No
## Practice location
- **Address:** 1100 WILFORD HALL LOOP, Lackland Afb, TX 78236-5638
- **Phone:** (210) 292-4897
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** July 14, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1538768114) · Data from the CMS NPPES public registry.