National Provider Identifier

Jordan Elizabeth Evanicki, PA-C

Jordan Elizabeth Evanicki, PA-C is listed in the NPPES registry with a primary specialty of Medical Physician Assistant in Rochester, NY and a listed phone number of (585) 275-9555.

NPI 1679974372Rochester, NYMedical Physician Assistant

Profile Overview

NPI
1679974372
Provider Type
Individual
Primary Specialty
Medical Physician Assistant
Enumeration Date
September 12, 2014
Last Updated
August 04, 2025

Practice Location

  • 601 Elmwood Ave
  • Rochester, NY 14642-5647

Phone: (585) 275-9555

Mailing Address

  • 601 Elmwood Ave Box 655
  • Rochester, NY 14642-8655

Specialties

  • Medical Physician Assistant (363AM0700X)
  • Physician Assistant (363A00000X)

Endpoints

  • jsmith96842@direct.urmc.rochester.edu

    Direct Messaging Address | Direct | Other | Rochester, NY 14642

Full Record
NPI
1679974372
Entity Type
Individual
Last Name
Evanicki
First Name
Jordan
Middle Name
Elizabeth
Credential
PA-C
Mailing Street Address
601 Elmwood Ave Box 655
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14642-8655
Mailing Country
US
Practice Street Address
601 Elmwood Ave
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14642-5647
Practice Country
US
Practice Phone
(585) 275-9555
Enumeration Date
September 12, 2014
Last Updated
August 04, 2025
Sex
Female
Sole Proprietor
No
Certification Date
August 04, 2025
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Medical Physician Assistant (363AM0700X), Physician Assistant (363A00000X)