Jerry Gordon

Primary specialty

ContractorTaxonomy code 171W00000X

Practice address

9238 John F Kennedy Blvd
Norht Bergen, NJ 07047

Phone

(718) 551-1580

Fax

(212) 888-6024

NPI assigned

Feb 14, 2025

Last updated

Feb 14, 2025By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Sunrise Community Care PC

  • Allergy Physician
  • North Bergen, NJ
  • NPI 1154050615
  NPD Authorized official
• Harmony Medical Care, PC

  • Allergy Physician
  • Staten Island, NY
  • NPI 1164151627
  Authorized official Same address or phone
• Spire Care Management LLC

  • Case Manager/Care Coordinator
  • Staten Island, NY
  • NPI 1912816174
  Authorized official Same address or phone
• Syntegra Services Inc

  • Clinical Medical Laboratory
  • Staten Island, NY
  • NPI 1942684659
  Authorized official Same address or phone

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

{
    "created_epoch": "1739491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1194520015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 HUDSON ST STE 301",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076016655",
            "telephone_number": "201-641-2125",
            "fax_number": "212-888-6024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9238 JOHN F KENNEDY BLVD",
            "city": "NORHT BERGEN",
            "state": "NJ",
            "postal_code": "07047",
            "telephone_number": "718-551-1580",
            "fax_number": "212-888-6024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "JERRY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-14",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.