Jennifer Rose Gordon, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

P5367 Issued in TX

Practice address

5301 Davis LN Ste 100
Austin, TX 78749-4061

Phone

(512) 615-2730

Fax

(512) 566-3612

NPI assigned

May 18, 2009

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Dermatology

Education

University of Iowa, RJ & L Carver College of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Westlake Dermatology PAGroup PAC ID 6305817230, 52 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

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 and National Provider Directory roles.

• Westlake Dermatology PA

  • Dermatology Physician
  • Austin, TX
  • NPI 1518939347
  Medicare reassignment Care Compare group NPD
• Westlake Dermatology PA

  • Dermatology Physician
  • Round Rock, TX
  • NPI 1477678993
  NPD
• Westlake Dermatology, PA

  • Dermatology Physician
  • Alamo Heights, TX
  • NPI 1265086045
  NPD

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

{
    "created_epoch": "1242604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549411200000",
    "number": "1073748281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 DAVIS LN STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787494061",
            "telephone_number": "512-615-2730",
            "fax_number": "512-666-3764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 DAVIS LN STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787494061",
            "telephone_number": "512-615-2730",
            "fax_number": "512-566-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "JENNIFER",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-18",
        "last_updated": "2019-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "P5367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER RECORD ID",
            "identifier": "8EK794",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Elizabeth Gordon, MD
• Clare Michelle Gordon, OTR
• David J Gordon II, D.D.S.
• Donna Sue Gordon, CRNA
• Francois Antoine Gordon, MD
• Melia Gordon, CD(DONA)
• Robert Hall Gordon, PH.D.
• Scott Thomas Gordon, DDS
• Tara L Gordon, APRN, FNP-BC
• Ashleigh Marie Gore, LCSW

• Dermatology Physician in Austin, TX
• Providers in Austin, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; 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.