DASHIELL JORDAN (MD) – Family Medicine Physician, NPI 1053632901

DASHIELL JORDAN (MD) is a healthcare provider. based in Lewiston, Maine. specializing in Family Medicine Physician. They hold the professional credentials MD. They hold a License No. TD171104 (ME). The NPI Number for DASHIELL JORDAN (MD) is 1053632901

Main info

Male
16 Years Of Experience
Accepts Medicare Assignment
Name
DASHIELL JORDAN (MD)
NPI
1053632901
Phone
(207) 777-8810
Address
99 CAMPUS AVE STE 201
Enumeration Date
15 June 2010
Last Update Date
21 July 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2077553434
Graduation Year
2010 (16 years ago)
PAC ID
4183884109
Group Practice PAC ID
0042101099
Professional Enrollment ID
I20140616000006
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:15State licenses:1Digital endpointsOther names

Provider Addresses for DASHIELL JORDAN (MD)

  • 99 CAMPUS AVE STE 201

    LEWISTON, ME 042406045

    Phone: (207) 777-8810

    Fax: (207) 777-8155

    Type: Location

  • PO BOX 1638

    ALBANY, NY 122011638

    Phone: (207) 777-4111

    Fax: (207) 783-6660

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-06-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140616000006IFamily PracticeMETBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes10369$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit5252$0
99214Established patient office or other outpatient visit, 30-39 minutes5042$0
View full utilization report →

Insurance plans in this area (ZIP 04240)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0042101099View full group profile

Reviews

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Frequently asked questions

Is DASHIELL JORDAN (MD) listed with a National Provider Identifier?
Yes — DASHIELL JORDAN (MD) has NPI 1053632901 on file in the registry.
Is there an active status for DASHIELL JORDAN (MD)?
For scheduling context, DASHIELL JORDAN (MD) is shown as active in the registry.
What expertise is attributed to DASHIELL JORDAN (MD)?
DASHIELL JORDAN (MD)'s specialty line reads Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is DASHIELL JORDAN (MD) associated with Lewiston?
Public fields place DASHIELL JORDAN (MD) around Lewiston, Maine. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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