JORDAN SAMUEL DEHAVEN DPM
NPI 1750510988
Podiatrist - Foot & Ankle Surgery in Bristol, RI

Q: What is Jordan Dehaven's NPI number?

The NPI number for Jordan Dehaven is 1750510988. It was assigned to this individual provider in the NPPES registry on July 9, 2009.

Q: What is Jordan Dehaven's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

Q: When was this NPI record last updated?

The NPPES record for Jordan Dehaven was last updated on July 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.

Active since July 09, 2009PECOS EnrolledAccepts Medicare Assignment

1180 HOPE ST, BRISTOL, RI 02809(401) 253-8900(401) 253-3131 Get Directions Write a Review

NPPES record last updated: July 23, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Jordan Samuel Dehaven Dpm NPPES

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

JORDAN SAMUEL DEHAVEN DPM (NPI 1750510988) is an individual foot & ankle surgery provider in Bristol, Rhode Island, licensed in Rhode Island (DPM00328) and active in the NPI registry since July 2009. He is enrolled in Medicare PECOS, is affiliated with Roger Williams Medical Center, and maintains a secondary practice location in Providence.

NPPES Registry Identity

NPI1750510988

Entity TypeIndividualMale

Primary Taxonomy213ES0103X

Provider Legal NameJORDAN SAMUEL DEHAVENCredential: DPM

Location Address1180 HOPE STBristol, RI 02809-1126

Mailing Address1180 Hope StBristol, RI 02809-1126 · (401) 253-8900 · Fax (401) 253-3131

Phone(401) 253-8900

Fax(401) 253-3131

Sole ProprietorNo

Medical School CMSNew York College Of Podiatric MedicineGraduated 2007

Enumeration DateJuly 9, 2009

Last NPPES UpdateJuly 23, 2025

NPPES CertifiedJuly 23, 2025

✔ NPI 1750510988 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers

Taxonomy Code213ES0103X

License✔ Licensed in RI · DPM00328

1180 HOPE ST, Bristol, RI 02809

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Secondary Practice Location 1

Location 1825 Chalkstone AveProvidence, RI 02908-4728 · Phone (401) 456-2451

Other Identifiers 1

MedicaidJD81548RI

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 Samuel Dehaven Dpm 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 ID9739211400

PECOS Enrollment IDI20100715000327

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

Medicare enrollment records show Jordan Dehaven reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Medical Associates Of Ri Inc

Same address

Internal Medicine

1180 HOPE ST
Bristol, RI 02809

Reassigned Medicare billing, Rhode Island enrollment
61 clinicians in this Medicare group

NPI 1538161161 (401) 253-8900

Chartercare Roger Williams Medical Center

13 mi

Internal Medicine

825 CHALKSTONE AVE
Providence, RI 02908

Reassigned Medicare billing, Rhode Island enrollment
96 clinicians in this Medicare group

NPI 1649009507 (401) 456-2000

Prospect Chartercare Rwmc, LLC

13 mi

Internal Medicine

825 CHALKSTONE AVE
Providence, RI 02908

Reassigned Medicare billing, Rhode Island enrollment
162 clinicians in this Medicare group

NPI 1285059287 (401) 456-2000

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

Areas of Expertise CMS Part B claims 13

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Trimming of dystrophic nails, any number G0127

Trimming of dystrophic nails involves the careful cutting and shaping of thickened or deformed nails. This is often required when nails are affected by conditions such as fungus or psoriasis. The procedure helps to reduce discomfort and improve nail health.

796 services237 patients

Removal of noncancer thickened skin growth, 2-4 growths 11056

This procedure involves the safe removal of 2-4 noncancerous thickened skin growths. It's typically done under local anesthesia. The process helps to alleviate discomfort and prevent potential complications. It's a standard, low-risk procedure.

511 services143 patients

Removal of fingernails or toenails, 1-5 nails 11720

This procedure involves the careful removal of 1-5 nails from fingers or toes. It's typically done to treat conditions like ingrown nails, fungal infections, or damaged nails. Local anesthesia is used for comfort, and the area heals over time with appropriate care.

445 services139 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

389 services191 patients

Removal of fingernails or toenails, 6 or more nails 11721

This procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.

337 services112 patients

Removal of noncancer thickened skin growth, 1 growth 11055

This procedure involves the removal of a thickened skin growth that is not cancerous. A healthcare professional will safely extract the growth, usually under local anesthesia. This process helps maintain skin health and prevent potential complications.

148 services44 patients

Injection, dexamethasone sodium phosphate, 1 mg J1100

Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.

121 services32 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

89 services89 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

56 services32 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

46 services34 patients

Aspiration and/or injection of fluid from small joint 20600

This procedure involves inserting a thin needle into a small joint to remove (aspirate) or inject fluid. It can help diagnose conditions, relieve discomfort, or administer medication directly into the joint. It's generally safe with minimal discomfort.

19 services14 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

17 services13 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

13 services13 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Roger Williams Medical Center

Acute Care Hospitals · Providence, RI

4/5 CMS rating

OwnershipProprietary

CMS Certification Number410004

Location825 Chalkstone AvenueProvidence, RI 02908 · Providence County

Emergency services

The Miriam Hospital

Acute Care Hospitals · Providence, RI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number410012

Location164 Summit AvenueProvidence, RI 02906 · Providence County

Emergency services

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.

RAQUEL ANDREA DIAZ MD

Internal Medicine