Active NPI
Robert Gordon, D.O.
- Pulmonary Disease Physician
- Stratford, NJ
National Provider Identifier
1013945799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 25MBO3186400
- Practice address
- 42 E Laurel Rd
Suite 3100
Stratford, NJ 08084-1354 - Phone
- (856) 566-7070
- Fax
- (856) 566-6952
- NPI assigned
- Jun 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 25MBO3186400 | NJ | Primary |
Addresses
Primary practice location
42 E Laurel Rd
Suite 3100
Stratford, NJ 08084-1354
Mailing address
42 E Laurel Rd
Suite 3100
Stratford, NJ 08084-1354
Phone (856) 566-7070
Other practice location 1
42 E Laurel Rd
Suite 3100
Stratford, NJ 08084-1354
Phone (856) 566-6859
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 290008695 | Other | NJ | RAILROAD MEDICARE |
| 1996509 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040811000114 | NJ | Practitioner - Emergency Medicine | 4082686944 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MBO3186400 | NJ | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rowansom Newjersey Institute for Successful Aging-Geriatric Psychiatry | Past | Accepting new patients | |
| Emergency Physician Associates of South Jersey P C | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Emergency Medicine Physician
- Voorhees, NJ
- NPI 1215965231
-
- Psychiatry Physician
- Stratford, NJ
- NPI 1881668846
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517875200000",
"number": "1013945799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42 E LAUREL RD",
"address_2": "SUITE 3100",
"city": "STRATFORD",
"state": "NJ",
"postal_code": "080841354",
"telephone_number": "856-566-7070",
"fax_number": "856-566-6952"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42 E LAUREL RD",
"address_2": "SUITE 3100",
"city": "STRATFORD",
"state": "NJ",
"postal_code": "080841354",
"telephone_number": "856-566-7070",
"fax_number": "856-566-6952"
}
],
"practiceLocations": [
{
"address_1": "42 E Laurel Rd",
"address_2": "Suite 3100",
"address_purpose": "LOCATION",
"city": "Stratford",
"state": "NJ",
"postal_code": "080841354",
"country_code": "US",
"telephone_number": "856-566-6859",
"fax_number": "856-566-6952",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GORDON",
"first_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-29",
"last_updated": "2018-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "NJ",
"license": "25MBO3186400",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "290008695",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1996509",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Stratford, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.