Matthew Ainey Gordon, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

3762 Issued in CT

Practice address

20 York St
3Rd Floor West Pavilion, Cticu
New Haven, CT 06510-3220

Phone

(203) 785-2702

Fax

(203) 785-3346

NPI assigned

Jan 25, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: mgordon364889@direct.ynhh.org

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485993600000",
    "number": "1003962804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "address_2": "3RD FLOOR WEST PAVILION, CTICU",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-785-2702",
            "fax_number": "203-785-3346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "address_2": "3RD FLOOR WEST PAVILION, CTICU",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-785-2702",
            "fax_number": "203-785-3346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "MATTHEW",
        "middle_name": "AINEY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2017-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "3762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Gordon, MD
• Derrick M Gordon, PH.D.
• Emily Louise Gordon, MD
• Griffin T Gordon, LMFT-A
• Jesse Gordon, LADC, LCSW
• Gerald A Gorecki, DPM
• Fred S Gorelick, MD
• Ashley H Goreshnik
• Sophia Gorgens, MD
• Ahmet Semih Gork, MD

• Surgical Physician Assistant in New Haven, CT
• Providers in New Haven, CT by specialty
• Surgical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.