Talia Sivan Gordon

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085009132 Issued in IL

Practice address

2500 W Higgins Rd Ste 1040
Hoffman Estates, IL 60169-2049

Phone

(847) 884-8096

Fax

(847) 490-0978

NPI assigned

Apr 2, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Touro Un Col of Osteopathic Medicine, New York, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pinnacle Dermatology SCGroup PAC ID 8628353380, 145 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.8 of 100Reported as group

Promoting interoperability

88

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Pinnacle Dermatology, SC

  • Dermatology Physician
  • Joliet, IL
  • NPI 1861930984
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1093344178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 734240",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606734240",
            "telephone_number": "815-744-8554",
            "fax_number": "630-495-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W HIGGINS RD STE 1040",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601692049",
            "telephone_number": "847-884-8096",
            "fax_number": "847-490-0978"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "738 W Northwest Hwy",
            "address_purpose": "LOCATION",
            "city": "Barrington",
            "state": "IL",
            "postal_code": "600102640",
            "country_code": "US",
            "telephone_number": "847-382-5111",
            "fax_number": "847-382-8993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "TALIA",
        "middle_name": "SIVAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-02",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "023491",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085009132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Isabel Gonzalez
• Jennifer Kimberly Gonzalez
• Karla Gonzalez I
• Frank Edward Gooby
• Jonathan Van Goranson-Ruiz
• Marie Ellen Gorman, MSW
• Anthony F Gorrie, LCPC
• Oksana Govdyak
• Stephen Tad Grabowski, MD
• Grace Dental P.C,

• Physician Assistant in Hoffman Estates, IL
• Providers in Hoffman Estates, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; 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.