Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jeremy W Jordan, PA

Individual provider Physician Assistant · NPI 1487378949

Jeremy W Jordan, PA is a Physician Assistant in Riverside, California. Qualified in 2022, 4 years ago. Practices with Robert Marriott Medical Corp, a 64-clinician group and accepts Medicare assignment. Licensed in Colorado.

Years since qualifying
4
Licensed in
CO
In the registry since
2022
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

11711 Collett Ave Apt 531
Riverside, CA 92505-3771
Phone: (707) 540-3712
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0007579 (CO)

Record details

NPI number1487378949
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 28, 2022
Last updated in NPPESSeptember 28, 2022
Certification dateSeptember 28, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Robert Marriott Medical Corp — 64 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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