Peter Eliot Gordon, M.D.

Primary specialty

Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X

License

203705 Issued in NY

Practice address

315 S Manning Blvd
Albany, NY 12208-1707

Phone

(518) 525-1563

Fax

(518) 285-8192

NPI assigned

Sep 15, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

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

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.

• Albany Medical College

  • Allergy & Immunology Physician
  • Albany, NY
  • NPI 1497921688
  Medicare reassignment NPD
• Healthcare Partners of Saratoga LTD

  dba Malta Med Emergent Care

  • Urgent Care Clinic/Center
  • Malta, NY
  • NPI 1700159613
  Medicare reassignment NPD
• Albany Medical College

  dba Albany Medical College Dept of Emergency Medicine

  • Emergency Medicine Physician
  • Albany, NY
  • NPI 1174553093
  NPD
• Albany Medical College

  dba Albany Med EmUrgent Care

  • Urgent Care Clinic/Center
  • Albany, NY
  • NPI 1386038925
  NPD
• Albany Medical College

  dba Albany Medical College Department of Medicine

  • Allergy & Immunology Physician
  • Albany, NY
  • NPI 1386689248
  NPD
• Albany Medical College

  dba Albany Medical College Dept of PM&R

  • Physical Medicine & Rehabilitation Physician
  • Albany, NY
  • NPI 1629008537
  NPD
• Chenango Memorial Hospital, Inc.

  • Family Medicine Physician
  • Norwich, NY
  • NPI 1467526889
  NPD (past)

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731110400000",
    "number": "1154316230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S MANNING BLVD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122081707",
            "telephone_number": "518-525-1563",
            "fax_number": "518-285-8192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "PETER",
        "middle_name": "ELIOT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2024-11-09",
        "certification_date": "2024-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NY",
            "license": "203705",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NY",
            "license": "203705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP - Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "315 S Manning Blvd",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122081707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kelley Goodman, L.M.S.W
• Cecelia Jeanne Gookin, M.S. O.T.R.
• Elana B Gordis, PH.D.
• Charles Gordon Jr., PA-C
• McKennalee Gloria Gordon, LPN
• Seth J Gordon, MD
• Shaina Gordon
• Christin Gorka
• James Gorman , Jr., C.T.R.S.
• Adam Gorman, PSY.D.

• Hospice and Palliative Medicine (Internal Medicine) Physician in Albany, NY
• Providers in Albany, NY by specialty
• Hospice and Palliative Medicine (Internal Medicine) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.