Kenneth L. Gordon, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

C36598 Issued in CA

Practice address

2080 Century Park East, #800
Los Angeles, CA 90067-2011

Phone

(310) 277-2727

Fax

(310) 553-2135

NPI assigned

Aug 10, 2006

Sex

Male

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 8

Medicare fee-for-service enrollment

Enrolled in CA

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

Ophthalmology

Education

Tulane University School of Medicine, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

American Eye Institute a Medical CorpGroup PAC ID 7012955107, 6 clinicians

Practice addresses (Care Compare)

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.

• American Eye Institute a Medical Corp

  • Ophthalmology Physician
  • Los Angeles, CA
  • NPI 1790891638
  Medicare reassignment Care Compare group NPD
• Healthcare Partners Affiliates Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593

  Ophthalmology

  Medicare reassignment NPD
• Apt, Gindi, Gordon & Kerman, M.D.'S Inc

  • Ophthalmology Physician
  • Los Angeles, CA
  • NPI 1518124858
  NPD (past) Authorized official
• Apt, Gindi, Gordon & Kerman, M.D.'S, Inc.

  • Ophthalmology Physician
  • Los Angeles, CA
  • NPI 1427027143
  NPD (past) Authorized official
• Healthcare Partners Affiliates Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Murrieta, CA
  • NPI 1760057269
  NPD
• Healthcare Partners Affiliates Medical Group

  • Addiction Medicine (Internal Medicine) Physician
  • Tustin, CA
  • NPI 1891981502
  NPD
• Advanced Vision Care

  • Ophthalmology Physician
  • Los Angeles, CA
  • NPI 1992992945
  NPD (past)
• Cedars-Sinai Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1639172372
  NPD (past)
• Nippon Medical Clinic

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1457397309
  NPD (past)
• Providence Saint John'S Health Center

  • General Acute Care Hospital
  • Santa Monica, CA
  • NPI 1124026273
  NPD (past)

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190851200000",
    "number": "1104837657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 CENTURY PARK EAST, #800",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900672011",
            "telephone_number": "310-277-2727",
            "fax_number": "310-553-2135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 CENTURY PARK EAST, #800",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900672011",
            "telephone_number": "310-277-2727",
            "fax_number": "310-553-2135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "KENNETH",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "C36598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "K.L. GORDON M.D. MES #",
            "identifier": "10019",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYE MED GROUP PROVIDER #",
            "identifier": "CA0783",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0071730",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "K.L. GORDON BL/SHLD #",
            "identifier": "00C365980",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "K.L. GORDON -DAVIS VISION",
            "identifier": "33106001",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "K.L. GORDON -BLOCK VISION",
            "identifier": "891978",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "K.L. GORDON MULTI-PLAN #",
            "identifier": "P-11051496",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA GROUP PROVIDER #",
            "identifier": "26923",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory Gordon
• Hugh E Gordon, DC
• James Huntley Gordon, M.D.
• Jason Gordon, PT, DPT
• Kaitlyn Gordon
• La Faune Yvette Gordon, PH.D.
• Laurel Gordon, MD
• Lindsay Leigh Gordon, PHARM.D.
• Lynn K Gordon, M.D., PH.D.
• Martin L Gordon, M.D.

• Ophthalmology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2007; 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.