Angela Alena Gorodkov, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

3844 Kala Dr
Abilene, TX 79606-1777

Phone

(503) 333-5933

NPI assigned

Dec 20, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: agorodkov1330061@ahs.direct-ci.com

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.

• Acs Primary Care Physicians Southwest, PA

  • Emergency Medicine Physician
  • Gainesville, TX
  • NPI 1538101019
  Medicare reassignment

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

{
    "created_epoch": "1734652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1093523276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3844 KALA DR",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796061777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3844 KALA DR",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796061777",
            "telephone_number": "503-333-5933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORODKOV",
        "first_name": "ANGELA",
        "middle_name": "ALENA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-20",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Gordon, PMHNP
• Richard L. Gore, D.D.S.
• Mandi Goretska, LMSW
• Katie Gorka
• Jennifer L Gorman, MS, RDN, LD
• Andrea Beth Gorsline
• Morgan Victoria Gossett, PT, DPT
• Tiffany Goswick, LPC
• Brianna Goulet, RBT
• Grace Residential Enterprises

• Physician Assistant in Abilene, TX
• Providers in Abilene, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.