Zadesha Gordon, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

800 Meadows Rd
Boca Raton, FL 33486-2304

Phone

(561) 955-5365

Fax

(561) 955-3577

NPI assigned

Jun 26, 2021

Last updated

Jun 26, 2021By the provider in NPPES

Sex

Female

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

Enrolled in MO

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

Specialty

Internal MedicineAlso: Geriatric Medicine

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Citizens Memorial HealthcareGroup PAC ID 4183528169, 144 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Citizens Memorial Hospice Hospice, Bolivar, MO, CCN 261508
• Citizens Memorial Hospital Hospital, Bolivar, MO, CCN 260195
• Citizens Memorial Healthcare Facility Nursing home, Bolivar, MO, CCN 265545
• Community Springs Healthcare Facility Nursing home, El Dorado Springs, MO, CCN 265446
• Parkview Health Care Facility Nursing home, Bolivar, MO, CCN 265519

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
• IA HMO C-SNP
• IA HMO

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.

• Citizens Memorial Healthcare

  • Surgery Physician
  • Bolivar, MO
  • NPI 1568566131
  Medicare reassignment Care Compare group NPD
• Citizens Memorial Healthcare

  dba CMH Willard Medical Center

  • Rural Health Clinic/Center
  • Willard, MO
  • NPI 1568127397
  NPD
• Citizens Memorial Health Care Foundation

  dba Citizens Memorial Health Care Facility

  • Skilled Nursing Facility
  • Bolivar, MO
  • NPI 1932188083
  NPD (past)

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

• Citizens Memorial Health Care Foundation

  dba Citizens Memorial Hospice

  • Community Based Hospice Care Agency
  • Bolivar, MO
  • NPI 1124157169
  Care Compare affiliation
• Citizens Memorial Health Care Foundation

  dba Parkview Health Care Facility

  • Skilled Nursing Facility
  • Bolivar, MO
  • NPI 1629057765

  Nursing home

  Care Compare affiliation
• Citizens Memorial Health Care Foundation

  dba Citizens Memorial Health Care Facility

  • Skilled Nursing Facility
  • Bolivar, MO
  • NPI 1932188083

  Nursing home

  Care Compare affiliation
• Citizens Memorial Health Care Foundation

  dba Community Springs Healthcare Facility

  • Skilled Nursing Facility
  • El Dorado Springs, MO
  • NPI 1942289095

  Nursing home

  Care Compare affiliation
• Citizens Memorial Hospital District

  dba Citizens Memorial Hospital

  • General Acute Care Hospital
  • Bolivar, MO
  • NPI 1003981549
  Care Compare affiliation

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

{
    "created_epoch": "1624665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624665600000",
    "number": "1023688736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MEADOWS RD",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334862304",
            "telephone_number": "561-955-5365",
            "fax_number": "561-955-3577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MEADOWS RD",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334862304",
            "telephone_number": "561-955-5365",
            "fax_number": "561-955-3577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "ZADESHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-26",
        "last_updated": "2021-06-26",
        "certification_date": "2021-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cameron Gordon
• Jessica Gordon, APRN
• Kristine Gordon
• Kyle Sebastian Gordon, MD
• Samuel A. S. Gordon, M.D.
• Laura Nicole Gorenshtein, DO
• Alexander Gorlin, DDS
• Katrin Gorman, APRN
• Alexander M Gorup, MD
• Robert Gorycki, DPT

• Student in an Organized Health Care Education/Training Program in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Student in an Organized Health Care Education/Training Program in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.