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

Mr. Shane Jordan, PA-C

Individual provider Physician Assistant · NPI 1982062576

Mr. Shane Jordan, PA-C is a Physician Assistant in New York, New York. Licensed in New York. Registered with an NPI since 2016.

Licensed in
NY
In the registry since
2016
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

80 Maiden Ln Ste 900
New York, NY 10038-4811
Phone: (917) 261-4414
Fax: (917) 261-4420
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 019466 (NY)

Record details

NPI number1982062576
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 10, 2016
Last updated in NPPESAugust 16, 2022
Certification dateAugust 16, 2022

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