Individual provider Active NPI

Gregg Gordon, MD

  • Ophthalmology Physician
  • Cambria HTS, NY
National Provider Identifier
1083657126
Registry record updated Mar 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
181037 Issued in NY
Practice address
20620 Linden Blvd
Cambria HTS, NY 11411-1524
Phone
(718) 479-6600
Fax
(718) 264-7080
NPI assigned
Jun 14, 2006
Last updated
Mar 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 181037 NY Primary

Addresses

Primary practice location

20620 Linden Blvd
Cambria HTS, NY 11411-1524

Mailing address

55 Water St
2ND Floor Cred Dept
New York, NY 10041-0004
Phone (646) 680-2888

Other practice location 1

180-05 Hillside Ave
Jamaica, NY 11432-4727
Phone (718) 526-6300

Other practice location 2

260 W. Sunrise Hwy, Ste. 200
Valley Stream, NY 11581-1015
Phone (516) 825-3600

Other practice location 3

1991 Marcus Ave, 2nd Floor
New Hyde Park, NY 11042-2057
Phone (516) 354-1600

Other practice location 4

96-10 Metropolitan Ave
Forest Hills, NY 11375-6625
Phone (718) 459-0400

Other practice location 5

88-31 55th Avenue
Suite 201
Elmhurst, NY 11373-4686
Phone (718) 899-6600

Other identifiers 1

IdentifierTypeStateIssuer
01190761MedicaidNY

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20060510000078 NY Practitioner - Ophthalmology 2466463104 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
181037NYMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advantagecare Physicians PC CurrentSince Jan 1, 2017 Accepting new patients
Advantagecare Physicians PC CurrentSince Jan 1, 2017 Accepting new patients
Anesthesia Patient Services, PLLC Past Accepting new patients

Locations

233 Nostrand Ave
Brooklyn, NY 11205
Phone (646) 680-1595

20620 Linden Blvd
Cambria Hts, NY 11411
Phone (718) 479-6600

8831 55th Ave
#201
Elmhurst, NY 11373

9610 Metropolitan Ave
Forest Hills, NY 11375
Phone (718) 459-0400

18005 Hillside Ave
Jamaica, NY 11432
Phone (718) 526-6300

441 9th Ave
New York, NY 10001
Phone (646) 680-1595

55 Water St
Fl 2
New York, NY 10041

1991 Marcus Ave
#2
North New Hyde Park, NY 11042
Phone (516) 354-1600

260 W Sunrise Hwy
Ste 200
Valley Stream, NY 11581
Phone (516) 825-3600

Interoperability endpoints

  • FHIR API: https://epwebapps.acpny.com/FHIRproxy/ACPNY/api/FHIR/R4

Organizations & group practices 3

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1083657126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WATER ST",
            "address_2": "2ND FLOOR CRED DEPT",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100410004",
            "telephone_number": "646-680-2888",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20620 LINDEN BLVD",
            "city": "CAMBRIA HTS",
            "state": "NY",
            "postal_code": "114111524",
            "telephone_number": "718-479-6600",
            "fax_number": "718-264-7080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "180-05 Hillside Ave",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "114324727",
            "country_code": "US",
            "telephone_number": "718-526-6300",
            "fax_number": "718-262-7064",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "260 W. Sunrise Hwy, Ste. 200",
            "address_purpose": "LOCATION",
            "city": "Valley Stream",
            "state": "NY",
            "postal_code": "115811015",
            "country_code": "US",
            "telephone_number": "516-825-3600",
            "fax_number": "516-872-5137",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1991 Marcus Ave, 2nd Floor",
            "address_purpose": "LOCATION",
            "city": "New Hyde Park",
            "state": "NY",
            "postal_code": "110422057",
            "country_code": "US",
            "telephone_number": "516-354-1600",
            "fax_number": "516-941-4677",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "96-10 Metropolitan Ave",
            "address_purpose": "LOCATION",
            "city": "Forest Hills",
            "state": "NY",
            "postal_code": "113756625",
            "country_code": "US",
            "telephone_number": "718-459-0400",
            "fax_number": "718-670-6479",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "88-31 55th Avenue",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "NY",
            "postal_code": "113734686",
            "country_code": "US",
            "telephone_number": "718-899-6600",
            "fax_number": "718-606-3881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "GREGG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "181037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01190761",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambria HTS, NY

Sources for this page

Verify at the official NPI Registry.