Individual provider Active NPI

Arthur Erwin Gordon, MD

  • Gynecology Physician
  • Phila, PA
National Provider Identifier
1063496636
Registry record updated Jul 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
MD 025617L Issued in PA
Practice address
9331 Old Bustleton Ave
Suite 203
Phila, PA 19115-4634
Phone
(215) 602-8900
Fax
(215) 602-8904
NPI assigned
Dec 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X MD 025617L PA Primary

Addresses

Primary practice location

9331 Old Bustleton Ave
Suite 203
Phila, PA 19115-4634

Mailing address

PO Box 820933
Phila, PA 19182-0933
Phone (215) 926-9010

Other identifiers 11

IdentifierTypeStateIssuer
1075777OtherPAKMHP
0052699000OtherPAINDEPENDENCE BLUE CROSS
160058909OtherPARR MEDICARE
001688938MedicaidPA
30038145OtherPAKMHP
0168893802OtherPAAMERICHOICE
2Y6155OtherPAHEALTH NET
5062OtherPABRAVO HEALTH
0002101OtherPAAETNA HMO
4556714OtherPAAETNA PPO
0168893801OtherPAAMERICHOICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 025617LPAMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Physician Inc. Past Accepting new patients
Temple Physicians Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: arthur.gordon@direct.einstein.edu

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, 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": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310947200000",
    "number": "1063496636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 820933",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191820933",
            "telephone_number": "215-926-9010",
            "fax_number": "215-226-8286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9331 OLD BUSTLETON AVE",
            "address_2": "SUITE 203",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191154634",
            "telephone_number": "215-602-8900",
            "fax_number": "215-602-8904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "ARTHUR",
        "middle_name": "ERWIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2011-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "PA",
            "license": "MD 025617L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KMHP",
            "identifier": "1075777",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "0052699000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "160058909",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001688938",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KMHP",
            "identifier": "30038145",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "0168893802",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "2Y6155",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRAVO HEALTH",
            "identifier": "5062",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "0002101",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "4556714",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "0168893801",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phila, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.