NPIMap

Individual provider Active NPI

Michael D. Gordon, M.D.

  • Internal Medicine Physician
  • Apopka, FL
National Provider Identifier
1013905629
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0047490 Issued in FL
Practice address
3191 E Semoran Blvd
Apopka, FL 32703-5943
Phone
(407) 788-6500
Fax
(407) 869-9400
NPI assigned
Oct 7, 2005
Last updated
Jun 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X ME0047490 FL
Internal Medicine Physician 207R00000X ME0047490 FL Primary

Addresses

Primary practice location

3191 E Semoran Blvd
Apopka, FL 32703-5943

Mailing address

3191 E Semoran Blvd
Apopka, FL 32703-5943
Phone (407) 788-6500

Other identifiers 1

IdentifierTypeStateIssuer
043827800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041123000380 FL Practitioner - Internal Medicine 6002871696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Loma Linda University School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
Hunt Club Medical PLCGroup PAC ID 7416994843, 8 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

3191 E Semoran Blvd
Apopka, FL 32703-5943
Phone (407) 788-6500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0047490FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hunt Club Medical PLC CurrentSince Jan 4, 2005 Accepting new patients

Locations

3191 Semoran Blvd
Apopka, FL 32703
Phone (407) 788-6500

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GCBBAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/GCBBAA/Endpoint/GCBBAA
  • Direct secure messaging: michael.gordon@hcm.eclinicaldirectplus.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1013905629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3191 E SEMORAN BLVD",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327035943",
            "telephone_number": "407-788-6500",
            "fax_number": "407-869-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3191 E SEMORAN BLVD",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327035943",
            "telephone_number": "407-788-6500",
            "fax_number": "407-869-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "MICHAEL",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "FL",
            "license": "ME0047490",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0047490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043827800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Apopka, FL

Sources for this page

Verify at the official NPI Registry.