Kelly Jordan, MD in Oakland, CA - Medicare Pediatrics

Kelly Jordan, MD is a medicare enrolled "Pediatrics - Pediatric Critical Care Medicine" physician in Oakland, California. Her current practice location is 747 52nd St, Oakland, California. You can reach out to her office (for appointments etc.) via phone at (510) 428-3331.

Kelly Jordan is licensed to practice in Washington (license number MD60945855) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1083060396.

Contact Information

	Kelly Jordan, MD
	747 52nd St, Oakland, CA 94609-1809
	(510) 428-3331
	Not Available

Map and Direction

Physician's Profile

Full Name	Kelly Jordan
Gender	Female
Speciality	Pediatrics - Pediatric Critical Care Medicine
Location	747 52nd St, Oakland, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1083060396
Provider Enumeration Date: 05/05/2016
Last Update Date: 12/20/2022

Medicare PECOS Information:

PECOS PAC ID: 8123402898
Enrollment ID: I20220829003737

Medical Identifiers

Medical identifiers for Kelly Jordan such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1083060396	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	MD60945855 (Washington)	Secondary
2080P0203X	Pediatrics - Pediatric Critical Care Medicine	333542 (Louisiana)	Secondary
390200000X	Student In An Organized Health Care Education/training Program	(* (Not Available))	Secondary
2080P0203X	Pediatrics - Pediatric Critical Care Medicine	MD60945855 (Washington)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kelly Jordan allows following entities to bill medicare on her behalf.

Entity Name	Monument Health Rapid City Hospital Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1275553463 PECOS PAC ID: 6002729506 Enrollment ID: O20070625000144

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelly Jordan is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Kelly Jordan, MD 3261 Franklin Ave E Apt 7, Seattle, WA 98102-3858 Ph: (949) 981-0626	Kelly Jordan, MD 747 52nd St, Oakland, CA 94609-1809 Ph: (510) 428-3331

Reviews and Comments

Pediatrics Doctors in Oakland, CA

Mrs. Natalie Plotkin, MS, ACPNP Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 747 52nd St, Oakland, CA 94609 Phone: 510-428-3484
Rebecca Romanov, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 747 52nd St, Oakland, CA 94609 Phone: 510-428-3331 Fax: 510-428-3331
Dr. Theodore John Chaconas, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 747 52nd St, Oakland, CA 94609 Phone: 510-428-3237 Fax: 510-601-3979
Dr. Robert E Mines Jr., M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 5715 Market St, Oakland, CA 94608 Phone: 510-652-5161 Fax: 510-652-4225
Spencer L Magargal, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 747 52nd St, Oakland, CA 94609 Phone: 510-428-3000
Dr. Arathi Lakhole, M.D, M.P.H Pediatrics Medicare: Medicare Enrolled Practice Location: 747 52nd St, Oakland, CA 94609 Phone: 510-428-3058
Kristen Lum, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 747 52nd St, Oakland, CA 94609 Phone: 510-428-3000

Kelly Jordan, MD - Medicare Pediatrics in Oakland, CA