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

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: August 16, 2026.

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 is a graduate of New York College Of Podiatric Medicine (2007).

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
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

Other Identifiers 1

MedicaidJD81548RI

Medicare Participation & PECOS CMS

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

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.

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

Hospital Affiliations CMS Care Compare

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

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.

Internal Medicine
1180 HOPE ST
BRISTOL, RI 02809
Podiatrist (Foot & Ankle Surgery)
1180 HOPE ST
BRISTOL, RI 02809
Internal Medicine
1180 HOPE ST
BRISTOL, RI 02809
Physical Therapist
1180 HOPE ST
BRISTOL, RI 02809
Radiology (Diagnostic Radiology)
1180 HOPE ST
BRISTOL, RI 02809
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1180 HOPE ST
BRISTOL, RI 02809
Nurse Practitioner (Family)
1180 HOPE ST
BRISTOL, RI 02809
Internal Medicine
1180 HOPE ST
BRISTOL, RI 02809

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 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.

Where is Jordan Dehaven located?

Jordan Dehaven practices at 1180 Hope St, Bristol, RI 02809. The listed phone number is (401) 253-8900.

What is Jordan Dehaven's specialty?

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

Is Jordan Dehaven enrolled in Medicare?

Yes. Jordan Dehaven 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.

Is Jordan Dehaven affiliated with any hospitals?

According to CMS data, Jordan Dehaven is affiliated with Roger Williams Medical Center.

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 12 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.