Individual provider Active NPI

Robert Gordon, D.O.

  • Pulmonary Disease Physician
  • Stratford, NJ
National Provider Identifier
1013945799
Registry record updated Feb 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
25MBO3186400 Issued in NJ
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

Updated by the provider on Feb 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
290008695OtherNJRAILROAD MEDICARE
1996509MedicaidNJ

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040811000114 NJ Practitioner - Emergency MedicinePractitioner - Pulmonary Disease 4082686944

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MBO3186400NJMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.