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

Jordan Kathleen Fanara, PA-C

Individual provider Medical Physician Assistant · NPI 1568146314

Jordan Kathleen Fanara, PA-C is a Physician Assistant in West Seneca, New York. Qualified in 2023, 3 years ago. Practices with Southgate Medical Group LLP, a 32-clinician group and accepts Medicare assignment.

Years since qualifying
3
In the registry since
2023
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1026 Union Rd
West Seneca, NY 14224-3445
Phone: (716) 712-0851
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X

Record details

NPI number1568146314
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 12, 2023
Last updated in NPPESJune 20, 2023
Certification dateJune 20, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Southgate Medical Group Llp — 32 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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