Individual provider Active NPI

Ronald S Gordon, MD

  • Emergency Medicine Physician
  • Daly City, CA
National Provider Identifier
1063460517
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35069626 Issued in OH
Practice address
901 Campus Dr Ste 206B
Daly City, CA 94015-4932
Phone
(650) 356-8800
NPI assigned
May 5, 2006
Last updated
Feb 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35069626 OH Primary

Addresses

Primary practice location

901 Campus Dr Ste 206B
Daly City, CA 94015-4932

Mailing address

53765 Via Dona
La Quinta, CA 92253-7841
Phone (216) 956-8994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250418001183 CA Practitioner - General Practice 9931180155 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35069626OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Hyperbaric Centers, LLC CurrentSince Jun 23, 2003 Accepting new patients
Ronald Gordon Medical Corporation CurrentSince Jan 29, 2025 Accepting new patients
Emergency Medicine Physicians of Cuyahoga County, LTD Emergency Medicine Past Accepting new patients
University Hospitals Cleveland Medical Center Past Accepting new patients
University Emergency Specialists of Bedford LLC Emergency Medicine Past Accepting new patients

Locations

901 Campus Dr
Ste 206B
Daly City, CA 94015
Phone (216) 965-3152

127 Public Sq
Ste 2400
Cleveland, OH 44114

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1063460517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53765 VIA DONA",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922537841",
            "telephone_number": "216-956-8994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 CAMPUS DR STE 206B",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940154932",
            "telephone_number": "650-356-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "RONALD",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35069626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daly City, CA

Sources for this page

Verify at the official NPI Registry.