Organization Active NPI

Martin N Gordon MD

  • Pulmonary Disease Physician
  • Beverly Hills, CA
National Provider Identifier
1184812489
Registry record updated Jul 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
G31316 Issued in CA
Legal business name
MARTIN N GORDON MD
Practice address
9401 Wilshire Blvd
Suite 515
Beverly Hills, CA 90212-2928
Phone
(310) 432-6260
NPI assigned
Oct 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2015

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

Authorized official

Name
Martin N Gordon, MDNPI 1447353313
Title
President
Phone
(310) 432-4260

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X G31316 CA Primary

Addresses

Primary practice location

9401 Wilshire Blvd
Suite 515
Beverly Hills, CA 90212-2928

Mailing address

9401 Wilshire Blvd
Suite 515
Beverly Hills, CA 90212-2928
Phone (310) 432-6260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060104001030 CA Part B Supplier - Clinic/Group Practice 9335162320 Receives reassigned benefits from 1 practitioner
Practice locations: Beverly Hills, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1077012Martin N Gordon MD9401 Wilshire Blvd #515, Beverly Hills, CA 90212Certificate of waiverNov 28, 2027

National Provider Directory

National Provider Directory
Tax ID family
Martin N Gordon MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436745600000",
    "number": "1184812489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9401 WILSHIRE BLVD",
            "address_2": "SUITE 515",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902122928",
            "telephone_number": "310-432-6260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9401 WILSHIRE BLVD",
            "address_2": "SUITE 515",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902122928",
            "telephone_number": "310-432-6260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN N GORDON MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-11",
        "last_updated": "2015-07-13",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-432-4260",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "G31316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.