JAN K BRYDON (MD) – Dermatology Physician, NPI 1053479980

JAN K BRYDON (MD) is a healthcare provider. based in Erie, Pennsylvania. specializing in Dermatology Physician. They hold the professional credentials MD. They hold a License No. MD029742E (PA). The NPI Number for JAN K BRYDON (MD) is 1053479980

Main info

Female
Sole Proprietor
48 Years Of Experience
Accepts Medicare Assignment
Name
JAN K BRYDON (MD)
NPI
1053479980
Phone
(814) 456-2245
Address
310 French Street
Enumeration Date
4 December 2006
Last Update Date
30 September 2020

Doctor Profile

Medical School Name
TEMPLE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
8144527246
Graduation Year
1978 (48 years ago)
PAC ID
2769642560
Group Practice PAC ID
3870405137
Professional Enrollment ID
I20120403000062

Contacts

Secure Messaging
jbrydon148730@direct.ahn.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

Provider Addresses for JAN K BRYDON (MD)

  • 310 French Street

    Suite 101

    Erie, PA 16507

    Phone: (814) 456-2245

    Fax: (814) 456-2245

    Type: Location

  • 305, West 24th Street, Little Italy, Erie, Erie County, Pennsylvania, 16502, United States

    ERIE, PA 165022666

    Phone: (814) 454-4484

    Type: Location

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: 2012-04-03

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
I20120403000062IDermatologyPATBD

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 16507)

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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: 3870405137View full group profile

Reviews

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Frequently asked questions

What federal number belongs to JAN K BRYDON (MD)?
The federal identifier for JAN K BRYDON (MD) is NPI 1053479980.
Is JAN K BRYDON (MD)'s NPI currently valid?
The extract we use shows JAN K BRYDON (MD) as active.
What does JAN K BRYDON (MD) treat or focus on?
Patients typically see JAN K BRYDON (MD) under the specialty Dermatology Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for JAN K BRYDON (MD)?
The page summarizes Erie, Pennsylvania for JAN K BRYDON (MD); expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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