MARIO JORDAN (APRN, PMHNP-BC) – Psychiatric/Mental Health Nurse Practitioner, NPI 1578014403

MARIO JORDAN (APRN, PMHNP-BC) is a healthcare provider. based in Lakewood, Ohio. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN, PMHNP-BC. They hold a License No. APRN.CNP.0034613 (OH). The NPI Number for MARIO JORDAN (APRN, PMHNP-BC) is 1578014403

Main info

Male
Sole Proprietor
4 Years Of Experience
Accepts Medicare Assignment
Name
MARIO JORDAN (APRN, PMHNP-BC)
NPI
1578014403
Phone
(216) 269-8527
Address
12900 LAKE AVE APT 1505
Enumeration Date
14 October 2016
Last Update Date
17 August 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2168441000
Graduation Year
2022 (4 years ago)
PAC ID
5698128841
Group Practice PAC ID
4789682493
Professional Enrollment ID
I20240124003042
Address ID
OH441061716CL11100AVEX300
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience51
Completeness75
Years active:9State licenses:2Digital endpointsOther names

14,984 NURSE PRACTITIONER in OH

Provider Addresses for MARIO JORDAN (APRN, PMHNP-BC)

  • 12900 LAKE AVE APT 1505

    LAKEWOOD, OH 441071554

    Phone: (216) 269-8527

    Type: Mailing

  • 12900 LAKE AVE APT 1101

    LAKEWOOD, OH 441071552

    Phone: (216) 269-8527

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $139.

Total Amount is formed as General ($139) + Research ($0) + Ownership ($0) = $139.

Last reported payment date: 2024-10-11 • Largest payer in this snapshot: ABBVIE INC. ($124).

Total Amount

$139

General + Research + Ownership

Payments

2

Total payment records

General Amount

$139

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-11

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$124
Indivior Inc.$15
View all Open Payments →|Open Payments Risk Radar →

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: 2024-01-24

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
I20240124003042INurse PractitionerOHTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 44107)

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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: 4789682493View full group profile
NameSpecialtyState
-OH
-MI
Hospitalist, Internal MedicineOH
-TX
-OH
Certified Registered Nurse Anesthetist (Crna)OH
-OH
O B S T E T R I C S/ G Y N E C O L O G YOH
-OH
-OH

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Frequently asked questions

Can I verify MARIO JORDAN (APRN, PMHNP-BC) with an NPI only?
You can start verification with NPI 1578014403 for MARIO JORDAN (APRN, PMHNP-BC), then check state licensing separately.
Is MARIO JORDAN (APRN, PMHNP-BC) listed as active for patients and plans?
The listing shows MARIO JORDAN (APRN, PMHNP-BC) as active in the NPI system.
What healthcare role does MARIO JORDAN (APRN, PMHNP-BC) hold?
Scheduling teams often label MARIO JORDAN (APRN, PMHNP-BC) under Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is MARIO JORDAN (APRN, PMHNP-BC) based?
MARIO JORDAN (APRN, PMHNP-BC) is tied to Lakewood, Ohio in the data we show; additional addresses may exist on the full record.
Is the information about MARIO JORDAN (APRN, PMHNP-BC) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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