Individual provider Active NPI

Andrew R Gordon, MD

  • Diagnostic Radiology Physician
  • Voorhees, NJ
National Provider Identifier
1184738916
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
25MA08077600 Issued in NJ
Practice address
100 Carnie Blvd Ste B5
Voorhees, NJ 08043-4514
Phone
(888) 909-7572
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD428107 PA
Diagnostic Radiology Physician 2085R0202X 25MA08077600 NJ Primary

Addresses

Primary practice location

100 Carnie Blvd Ste B5
Voorhees, NJ 08043-4514

Mailing address

100 Carnie Blvd Ste B5
Voorhees, NJ 08043-4514

Other practice location 1

1 Medical Center Blvd
Upland, PA 19013-3995
Phone (610) 447-2500

Other identifiers 2

IdentifierTypeStateIssuer
25MA08077600OtherNJSTATE OF NJ
MD428107OtherPAPA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060922000054 PA Practitioner - Diagnostic Radiology 6709881931 Reassigns benefits to 1 organization
I20220810000719 NJ Practitioner - Diagnostic Radiology 6709881931 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Perelman School of Med at the University of Pennsylvania, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Jersey Radiology Associates P aGroup PAC ID 9133115587, 202 clinicians
Radiology Associates of Burlington County P aGroup PAC ID 7012954381, 153 clinicians
Larchmont Imaging AssociatesGroup PAC ID 5193762433, 54 clinicians

Practice addresses (Care Compare)

100 Carnie Blvd
Suite B5
Voorhees, NJ 08043-4514
Phone (888) 909-7572

175 Madison Ave
Mount Holly, NJ 08060-2038
Phone (609) 267-0700

210 Ark Rd
Mount Laurel, NJ 08054-3188
Phone (609) 261-4500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.75 of 100Reported as group
Quality
75
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
83.17 of 100Reported as group
Quality
75
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
78.75 of 100Reported as group
Quality
75
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Radiology LTD Diagnostic Radiology CurrentSince Jul 1, 2007 Accepting new patients
Radiology Associates of Burlington County P a Diagnostic Radiology CurrentSince Aug 1, 2022 Accepting new patients
Larchmont Imaging Associates Diagnostic Radiology CurrentSince Aug 1, 2022 Accepting new patients
East Norriton Physicians Services Past Accepting new patients

Locations

700 E Morehead St
Ste 300
Charlotte, NC 28202
Phone (704) 442-4390

175 Madison Ave
Mount Holly, NJ 08060
Phone (609) 261-1660

210 Ark Rd
Mount Laurel, NJ 08054
Phone (609) 261-4500

1 Medical Center Blvd
Chester, PA 19013
Phone (610) 447-6666

300 Evergreen Dr
Ste 210
Glen Mills, PA 19342
Phone (610) 566-9400

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1184738916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CARNIE BLVD STE B5",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CARNIE BLVD STE B5",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434514",
            "telephone_number": "888-909-7572"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Upland",
            "state": "PA",
            "postal_code": "190133995",
            "country_code": "US",
            "telephone_number": "610-447-2500",
            "fax_number": "610-956-0069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "ANDREW",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD428107",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA08077600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF NJ",
            "identifier": "25MA08077600",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "MD428107",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

Verify at the official NPI Registry.