Bradley Gordan, DO

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

02006650A Issued in IN

Practice address

500 Arcade Ave Ste 320
Elkhart, IN 46514-2477

Phone

(574) 523-7900

Fax

(574) 523-7909

NPI assigned

Apr 13, 2013

Last updated

Apr 28, 2023By the provider in NPPES

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 2

Medicare fee-for-service enrollment

Enrolled in IA

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

General Surgery

Education

Nova Southeastern College of Osteo Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Medical CenterGroup PAC ID 4183535271, 295 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Medical Center - Cedar Rapids Hospital, Cedar Rapids, IA, CCN 160079

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mercy Medical Center

  dba Mercy Family Counseling, Mercy Psychiatric

  • Psychiatry Physician
  • Cedar Rapids, IA
  • NPI 1700834165
  Medicare reassignment Care Compare group NPD
• Mercy Medical Center

  dba Hall Perrine Cancer Center Pharmacy

  • Community/Retail Pharmacy
  • Cedar Rapids, IA
  • NPI 1114923513
  NPD
• Mercy Medical Center

  dba Mercy Professional Services

  • Cardiovascular Disease Physician
  • Cedar Rapids, IA
  • NPI 1669617106
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Medical Center

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1720029333
  Care Compare affiliation

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

{
    "created_epoch": "1365811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1134562762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380",
            "telephone_number": "574-647-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 ARCADE AVE STE 320",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465142477",
            "telephone_number": "574-523-7900",
            "fax_number": "574-523-7909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Arcade Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "465142486",
            "country_code": "US",
            "telephone_number": "574-389-7362",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Arcade Ave Ste 210",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "465142485",
            "country_code": "US",
            "telephone_number": "574-389-5656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDAN",
        "first_name": "BRADLEY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-13",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "02006650A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134562762",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300060816",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Juliana Gonsalves, FNP
• Luisito C. Gonzales, M.D.
• Jennifer Gonzalez
• Victoria Gonzalez
• Alexandra Goodin
• Aimy Gordon, COTA
• Amy Gose, PTA
• Goshen Health System, Inc (Goshen Physicians)
• Goshen Health System, Inc (Goshen Physicians)
• Jamie Gosztola, LSW

• Surgery Physician in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2023; 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.