Michael Elijah Gordon Jr., M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

243854 Issued in NY

Practice address

1001 West St
Carthage, NY 13619-9703

Phone

(315) 493-1001

NPI assigned

May 10, 2007

Last updated

Feb 15, 2016By the provider in NPPES

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

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Carthage Area Hospital Inc

  • Critical Access Hospital
  • Carthage, NY
  • NPI 1053497388
  Medicare reassignment NPD
• Carthage Area Hospital, Inc.

  • Critical Access Hospital
  • Carthage, NY
  • NPI 1104234376
  Medicare reassignment NPD
• Claxton-Hepburn Medical Center

  dba Practice Resources LLC

  • Psychiatric Hospital
  • Ogdensburg, NY
  • NPI 1891753034
  Medicare reassignment NPD
• Carthage Area Hospital Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Ogdensburg, NY
  • NPI 1013759166
  NPD
• Carthage Area Hospital Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Carthage, NY
  • NPI 1801007364
  NPD

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455494400000",
    "number": "1033323993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 WEST ST",
            "city": "CARTHAGE",
            "state": "NY",
            "postal_code": "136199761",
            "telephone_number": "315-771-5422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 WEST ST",
            "city": "CARTHAGE",
            "state": "NY",
            "postal_code": "136199703",
            "telephone_number": "315-493-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "MICHAEL",
        "middle_name": "ELIJAH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2016-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "243854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa May Forney, RDN, CDN, LPN, CDCES
• Natashya M. Fraser, DDS
• Morgan Freeman, RN
• Tammy Lynn Gebo, LPN
• Kimberly Michele Ginyard, M.D.
• Kaliope Goutis
• James T Gratch, RPH
• Jeri Lynn Gray, LMSW
• Angie M Greenfield
• Christopher Paul Grudowski, MSN/FNP

• Anesthesiology Physician in Carthage, NY
• Providers in Carthage, NY by specialty
• Anesthesiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; 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.

Verify at the official NPI Registry.