Jordan At Ccia - Medicare Primary Care in Canandaigua, NY

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Jordan At Ccia is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Canandaigua, New York. The current practice location for Jordan At Ccia is 120 N Main St, Suite 11, Canandaigua, New York. For appointments, you can reach them via phone at (585) 396-6980. The mailing address for Jordan At Ccia is 82 Holland Street, Rochester, New York and phone number is () -.

Jordan At Ccia is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1649529678. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (585) 396-6980.

Contact Information

Jordan At Ccia
120 N Main St
Suite 11
Canandaigua
NY 14424-1258
(585) 396-6980
Not Available

Map and Direction


Primary Care Clinic Profile

Full NameJordan At Ccia
SpecialityClinic/Center
Location120 N Main St, Canandaigua, New York
Authorized Official Name and PositionBridgette Wiefling (PRESIDENT/CEO)
Authorized Official Contact5854232878
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jordan At Ccia
82 Holland Street
Rochester
NY 14605-2131

Ph: () -		Jordan At Ccia
120 N Main St
Suite 11
Canandaigua
NY 14424-1258

Ph: (585) 396-6980

NPI Details:

NPI Number1649529678
Provider Enumeration Date09/06/2012
Last Update Date09/07/2012

Medicare PECOS Information:

Medicare PECOS PAC ID8729079785
Medicare Enrollment IDO20040519001335

Medical Identifiers

Medical identifiers for Jordan At Ccia such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1649529678NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QF0400XClinic/center - Federally Qualified Health Center (fqhc) (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Jordan At Ccia acts as a billing entity for following providers:
Provider NameRichard G Kennedy
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1881659845
PECOS PAC ID: 4880596683
Enrollment ID: I20040122000797
Provider NameColleen T Fogarty
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1801816954
PECOS PAC ID: 0143219824
Enrollment ID: I20040507001242
Provider NameSteven G Becker
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1861441404
PECOS PAC ID: 8729079603
Enrollment ID: I20040519001500
Provider NameSandra L Coleman
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1801810874
PECOS PAC ID: 5092791137
Enrollment ID: I20040628001592
Provider NameBasya V Herbert
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1912943812
PECOS PAC ID: 6709848724
Enrollment ID: I20041102000510
Provider NameAssaf Yosha
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1558397752
PECOS PAC ID: 9133186497
Enrollment ID: I20041217000714
Provider NameJohn C Dickinson
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1487686622
PECOS PAC ID: 5193745461
Enrollment ID: I20051201000171
Provider NameSteven M Fine
Provider TypePractitioner - Infectious Disease
Provider IdentifiersNPI Number: 1780682351
PECOS PAC ID: 5395759120
Enrollment ID: I20060201000387
Provider NameKatherine P O Hanlon
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1134152275
PECOS PAC ID: 5698781094
Enrollment ID: I20060222000386
Provider NameLaurie J Donohue
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1114949948
PECOS PAC ID: 1658382650
Enrollment ID: I20060505000082
Provider NameLeslie E Purnell
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1689621500
PECOS PAC ID: 6103839287
Enrollment ID: I20060712000143
Provider NameKara Lee Eastwood
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1659310522
PECOS PAC ID: 3779556907
Enrollment ID: I20060929000342
Provider NameGail A Long
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1700908811
PECOS PAC ID: 3375634629
Enrollment ID: I20070822000353
Provider NameMary C Angerame
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1093886830
PECOS PAC ID: 4486743861
Enrollment ID: I20071207000808
Provider NameBenjamin Ray Christensen
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1801805585
PECOS PAC ID: 9234214701
Enrollment ID: I20080307000230
Provider NameEllen M Ingram
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1730363383
PECOS PAC ID: 5294814786
Enrollment ID: I20080508000744
Provider NameLinda Levita Clark
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1720249147
PECOS PAC ID: 4587736921
Enrollment ID: I20080701000029
Provider NameDiane S Morse
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1770552341
PECOS PAC ID: 1850465303
Enrollment ID: I20080801000327
Provider NameColby Ah Previte
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1801805320
PECOS PAC ID: 9638238058
Enrollment ID: I20081030000101
Provider NameKatrina F Nicandri
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1316056286
PECOS PAC ID: 9739286469
Enrollment ID: I20090807000241
Provider NameLeesha Kerene Hoilette
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1881767150
PECOS PAC ID: 1759475437
Enrollment ID: I20090825000587
Provider NameWilhelmina Sizer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1689851164
PECOS PAC ID: 1153499140
Enrollment ID: I20091015000518
Provider NameBradley Vanheukelum
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1841213022
PECOS PAC ID: 9537207188
Enrollment ID: I20091119000110
Provider NameJeanne C Beddoe
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1902847882
PECOS PAC ID: 7618006255
Enrollment ID: I20100520000342
Provider NameRoksolana Kuchma
Provider TypePractitioner - Geriatric Medicine
Provider IdentifiersNPI Number: 1063435238
PECOS PAC ID: 9931233095
Enrollment ID: I20100812000009
Provider NameJonathan W Hager
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1114941846
PECOS PAC ID: 8921184904
Enrollment ID: I20101101000640
Provider NameCarole J Peterson
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1639132798
PECOS PAC ID: 4486698230
Enrollment ID: I20101208000841
Provider NameLaura L Hayton Oechsle
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1902120124
PECOS PAC ID: 9234310418
Enrollment ID: I20110221000981
Provider NameHolly A Russell
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1013123389
PECOS PAC ID: 7719161868
Enrollment ID: I20110413001028
Provider NameNashat Atalla
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1245208065
PECOS PAC ID: 8921020934
Enrollment ID: I20110516000194
Provider NameSoon Il Song
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1063464386
PECOS PAC ID: 1759381213
Enrollment ID: I20110802000424
Provider NameSakinah N Miller
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1538173679
PECOS PAC ID: 1557530318
Enrollment ID: I20110811000549
Provider NameHeidi R Zinkand
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1225056294
PECOS PAC ID: 4284804626
Enrollment ID: I20110823000430
Provider NameFaith Debra Adams
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1316914609
PECOS PAC ID: 7911171954
Enrollment ID: I20111201000027
Provider NameKevin A Fiscella
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1144332818
PECOS PAC ID: 2769622562
Enrollment ID: I20130627000665
Provider NameElizabeth L Loomis
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1063647915
PECOS PAC ID: 4284890880
Enrollment ID: I20130806000262
Provider NameJ Derek Brederson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1790063162
PECOS PAC ID: 5890921431
Enrollment ID: I20131204000337
Provider NameLorinda F Parks
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1275617979
PECOS PAC ID: 2961597836
Enrollment ID: I20140108001321
Provider NameLiz Munoz
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1962613174
PECOS PAC ID: 8022246040
Enrollment ID: I20140120000087
Provider NameThecla I Obi
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1679801633
PECOS PAC ID: 0840424743
Enrollment ID: I20140224001499
Provider NameMelanie Murphy
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1609142587
PECOS PAC ID: 3274758826
Enrollment ID: I20140715002134
Provider NameJericho Banker
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1518220441
PECOS PAC ID: 6002032976
Enrollment ID: I20140730000016
Provider NameThomas Robert Gregg
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1639339146
PECOS PAC ID: 2365760899
Enrollment ID: I20150414001280
Provider NamePrity J Rawal
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1851650998
PECOS PAC ID: 8426287095
Enrollment ID: I20150828000342
Provider NameEmily J Thompson-carrillo
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1639468275
PECOS PAC ID: 5193033173
Enrollment ID: I20150925000445
Provider NameBlessing A Ibezim
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1174914964
PECOS PAC ID: 4981912904
Enrollment ID: I20160303000735
Provider NameLara Lynn Busch
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1750577888
PECOS PAC ID: 8224329362
Enrollment ID: I20160621002495
Provider NameMary Li Ma
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1356606263
PECOS PAC ID: 7517267149
Enrollment ID: I20160819000736
Provider NameRosamond Reffell-pugh
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1891087771
PECOS PAC ID: 7618256421
Enrollment ID: I20161118001933
Provider NameHollis Ann Biggs
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1164781498
PECOS PAC ID: 8628359718
Enrollment ID: I20170104000430
Provider NameVladimir Taub
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1992250997
PECOS PAC ID: 2264716471
Enrollment ID: I20170308001101
Provider NameEmily Kathleen Jerge
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1235590282
PECOS PAC ID: 9234414228
Enrollment ID: I20170313001725
Provider NameBess M Griffin
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1336688993
PECOS PAC ID: 2668759606
Enrollment ID: I20170501001252
Provider NameMegan N Finch
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1952762270
PECOS PAC ID: 0446545990
Enrollment ID: I20170601002685
Provider NameLawrence Shawndel Brumfield
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1750695615
PECOS PAC ID: 8426326406
Enrollment ID: I20170615001075
Provider NameBranko Matich
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1023437704
PECOS PAC ID: 4981974854
Enrollment ID: I20170726000178
Provider NameSarah Elizabeth Hudson
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1740417039
PECOS PAC ID: 8820233364
Enrollment ID: I20170801003125
Provider NameDanielle B Fleissig
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1073932315
PECOS PAC ID: 8628349008
Enrollment ID: I20170803000009
Provider NameColleen A Obrien
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1487162533
PECOS PAC ID: 7113287137
Enrollment ID: I20180212001238
Provider NameAnne M Goodman
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1821581711
PECOS PAC ID: 1456608363
Enrollment ID: I20180724002543
Provider NameMegan E Betteley Wang
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1083092910
PECOS PAC ID: 5890042501
Enrollment ID: I20180725002802
Provider NameDavya S. Brody
Provider TypePractitioner - Certified Nurse Midwife (cnm)
Provider IdentifiersNPI Number: 1164735320
PECOS PAC ID: 6305198268
Enrollment ID: I20181004001699
Provider NameMeghan Pratts O'connor
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1164711370
PECOS PAC ID: 3173775756
Enrollment ID: I20181022002532
Provider NameFanny Lean Ho
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1649774183
PECOS PAC ID: 8022362276
Enrollment ID: I20181107001036
Provider NameJennifer A Ashley
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1992175681
PECOS PAC ID: 5890035232
Enrollment ID: I20190320002864
Provider NameNicole B Erlichman
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1992212799
PECOS PAC ID: 6002140167
Enrollment ID: I20190624000680
Provider NameLauren N Hobbs
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1831545516
PECOS PAC ID: 7012260078
Enrollment ID: I20190624002760
Provider NameKimberlie A Noyes
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1700429461
PECOS PAC ID: 1850729658
Enrollment ID: I20200310000124
Provider NameAvellina Ihuaku Okafor
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1073159679
PECOS PAC ID: 8820426562
Enrollment ID: I20200312000485
Provider NameCaroline Rb Donohue
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1730614843
PECOS PAC ID: 6204189194
Enrollment ID: I20200612000860
Provider NameNicholas D David
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1740715564
PECOS PAC ID: 5991075962
Enrollment ID: I20200914000188
Provider NameNina G Piazza
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1659805026
PECOS PAC ID: 5294005054
Enrollment ID: I20200919000010
Provider NameMichelle Magee Devens
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1629603998
PECOS PAC ID: 6204255409
Enrollment ID: I20201007000503
Provider NameLisa M Denmark
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1912528142
PECOS PAC ID: 6002226016
Enrollment ID: I20201103001334
Provider NameLacarla Denise Holmes
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1760682751
PECOS PAC ID: 3072924141
Enrollment ID: I20201120000514
Provider NameLillian A Riley
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1730709296
PECOS PAC ID: 7416360995
Enrollment ID: I20201229002414
Provider NameSara Joyce Klatte
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1124491592
PECOS PAC ID: 8921390998
Enrollment ID: I20210401001764
Provider NameTariq Jamal Ahmed
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1235627472
PECOS PAC ID: 4082951488
Enrollment ID: I20210817002692
Provider NameDzheikhuna Mamedova
Provider TypePractitioner - Dentist
Provider IdentifiersNPI Number: 1952953945
PECOS PAC ID: 9234541467
Enrollment ID: I20210819000355
Provider NameMatthew T Rivera
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1598256190
PECOS PAC ID: 4183977143
Enrollment ID: I20210901001904
Provider NameJaslynn Renee Wilson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1790350890
PECOS PAC ID: 1052701976
Enrollment ID: I20211208003505
Provider NameJason Stewart
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1801568613
PECOS PAC ID: 4385038892
Enrollment ID: I20220228000425
Provider NameSarah M Tiggelaar
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1376806851
PECOS PAC ID: 7113172651
Enrollment ID: I20230113001633

Reviews and Comments


Clinic/Center in Canandaigua, NY

Fingerlakes Family Care
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Medicare: Not Enrolled in Medicare
Practice Location: 241 Parrish St, Suite B, Canandaigua, NY 14424
Phone: 585-394-8170    Fax: 585-394-8173
Clemensen Family Medicine
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Medicare: Not Enrolled in Medicare
Practice Location: 181 S Main St, Suite 5, Canandaigua, NY 14424
Phone: 866-269-4810    Fax: 866-269-4810
Laurel A Dallmeyer
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Medicare: Not Enrolled in Medicare
Practice Location: 495 N Main St, Canandaigua, NY 14424
Phone: 585-393-3515    Fax: 585-393-3515
Bloomfield Family Practice, P.c.
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 6032 Woodvine Rise, Canandaigua, NY 14424
Phone: 585-202-5022    
Canandaigua Medical Group, P.c.
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 335 Parrish St, Canandaigua, NY 14424
Phone: 585-393-2888    Fax: 585-396-9275
Lake Country Family Medicine, P.c.
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 502 S Main St, Suite G, Canandaigua, NY 14424
Phone: 585-394-1875    Fax: 866-285-9069

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.