Individual provider Active NPI

Matthew Craig Gordon, M.D.

  • Dermatology Physician
  • Issaquah, WA
National Provider Identifier
1093007767
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD70059021 Issued in WA
Practice address
1301 4TH Ave NW Ste 302
Issaquah, WA 98027-9371
Phone
(206) 957-9329
Fax
(253) 839-7166
NPI assigned
May 12, 2011
Last updated
Jun 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 52503 TN
Dermatology Physician 207N00000X MD70059021 WA Primary
Dermatology Physician 207N00000X ME113912 FL

Addresses

Primary practice location

1301 4TH Ave NW Ste 302
Issaquah, WA 98027-9371

Mailing address

1793 13TH St SE
Salem, OR 97302-2541
Phone (503) 362-8385

Other practice location 1

7658 Poplar Pike
Germantown, TN 38138
Phone (901) 759-2322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20151210002201 TN Practitioner - Dermatology 8729227665 Reassigns benefits to 1 organization
I20260318004364 WA Practitioner - Dermatology 8729227665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Tennessee, HSC, College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Levy Dermatology, PCGroup PAC ID 9032263538, 15 clinicians
Silver Falls Dermatology LLCGroup PAC ID 5890863492, 100 clinicians

Practice addresses (Care Compare)

6254 Poplar Ave
Memphis, TN 38119-4713
Phone (901) 624-3333

8435 SE 68TH St
Suite 118
Mercer Island, WA 98040-5249
Phone (206) 232-7546

Merit-based Incentive Payment System (MIPS)

Final score
71.38 of 100Reported as individual
Quality
52.88
Promoting interoperability
91
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision186
Removal of skin lesions972
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy440

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Falls Dermatology, LLC Dermatology CurrentSince Apr 1, 2026 Accepting new patients
Silver Falls Dermatology, LLC CurrentSince Apr 1, 2026 Accepting new patients
Levy Dermatology, PC Dermatology CurrentSince Dec 12, 2023 Accepting new patients
Dr. Adam T Keres LLC. PastSince Dec 12, 2023 Accepting new patients

Locations

1793 13th St SE
Salem, OR 97302
Phone 50336283851283

6254 Poplar Ave
Memphis, TN 38119
Phone (901) 624-3333

1515 116th Ave NE
Ste 307
Bellevue, WA 98004
Phone (425) 999-2628

1301 4th Ave NW
Ste 302
Issaquah, WA 98027
Phone (206) 305-9963

8435 SE 68th St
Ste 118
Mercer Island, WA 98040
Phone (206) 232-7546

Organizations & group practices 4

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": "1305158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781049600000",
    "number": "1093007767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1793 13TH ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022541",
            "telephone_number": "503-362-8385",
            "fax_number": "503-362-8435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 4TH AVE NW STE 302",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980279371",
            "telephone_number": "206-957-9329",
            "fax_number": "253-839-7166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7658 Poplar Pike",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "38138",
            "country_code": "US",
            "telephone_number": "901-759-2322",
            "fax_number": "901-759-2077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "MATTHEW",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-12",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TN",
            "license": "52503",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD70059021",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME113912",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

Verify at the official NPI Registry.