NPIMap

Individual provider Active NPI

Andrew John Gordon, MD, FACS

  • Surgery Physician
  • Kalamazoo, MI
National Provider Identifier
1194761924
Registry record updated Jan 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4301067751 Issued in MI
Practice address
601 John St Ste M-283
Kalamazoo, MI 49007-5382
Phone
(269) 349-7696
NPI assigned
Jun 21, 2006
Last updated
Jan 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X AG067751 MI
Surgery Physician 208600000X 4301067751 MI Primary

Addresses

Primary practice location

601 John St Ste M-283
Kalamazoo, MI 49007-5382

Mailing address

601 John St Ste M-283
Kalamazoo, MI 49007-5382
Phone (269) 349-7696

Other practice location 1

215 E Mansion St
Suite 3E
Marshall, MI 49068-1559
Phone (269) 781-4267

Other identifiers 3

IdentifierTypeStateIssuer
4227783MedicaidMI
4848964MedicaidMI
020A312720OtherMIBCBSM GROUP ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040115000257 MI Practitioner - General Surgery 1254230923 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Wayne State University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bronson Lakeview HospitalGroup PAC ID 9032008495, shared by 6 NPIs, 72 clinicians
Bronson Methodist HospitalGroup PAC ID 0244148633, 721 clinicians

Practice addresses (Care Compare)

404 Hazen St
Suite 101
Paw Paw, MI 49079-1075
Phone (269) 657-4407

451 Health Pkwy
Paw Paw, MI 49079-8242

451 Health Pkwy E
Bronson Lakeview Pediatrics
Paw Paw, MI 49079-8242
Phone (269) 655-3090

601 John St
283A
Kalamazoo, MI 49007-5341
Phone (269) 349-7696

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.43 of 100Reported as group
Quality
75.38
Promoting interoperability
100
Improvement activities
40
Cost
79.38

Merit-based Incentive Payment System (MIPS)

Final score
93.89 of 100Reported as group
Quality
95.63
Promoting interoperability
100
Improvement activities
40
Cost
84

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AG067751MIMDSpecialist
4301067751MIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ella E M Brown Charitable Circle CurrentSince Dec 3, 2013 Accepting new patients
Bronson South Haven Hospital CurrentSince Aug 1, 2025 Accepting new patients
Bronson Lakeview Hospital Surgery CurrentSince Feb 2, 2020 Accepting new patients
Bronson South Haven Hospital CurrentSince Aug 1, 2025 Accepting new patients
Ella E M Brown Charitable Circle CurrentSince Dec 3, 2013 Accepting new patients
Bronson Methodist Hospital CurrentSince Feb 2, 2020 Accepting new patients
Patholgy Services of Kalamazoo, PC Current Accepting new patients
Bronson Lakeview Hospital CurrentSince Feb 2, 2020 Accepting new patients
Bronson Lakeview Hospital Current Accepting new patients
The Doctors Group, P.C. Past Accepting new patients
General Surgical Associates PC Specialist Past Accepting new patients
Bronson Methodist Hospital Past Accepting new patients

Locations

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

601 John St
Ste M-283
Kalamazoo, MI 49007
Phone (269) 349-7696

200 N Madison St
Marshall, MI 49068
Phone (269) 789-3921

215 E Mansion St
Ste 3E
Marshall, MI 49068
Phone (269) 753-0640

408 Hazen St
Paw Paw, MI 49079
Phone (269) 341-8481

451 Health Pkwy
Paw Paw, MI 49079
Phone (269) 655-1725

940 Blue Star Hwy
South Haven, MI 49090
Phone (269) 263-2976

950 S Bailey Ave
South Haven, MI 49090
Phone (269) 639-2796

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/8ce5d363-ea3e-4f6f-a99f-e6d83ae8306f/

Organizations & group practices 12

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.

Hospital & facility affiliations 3

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": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578873600000",
    "number": "1194761924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 JOHN ST STE M-283",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075382",
            "telephone_number": "269-349-7696",
            "fax_number": "269-349-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 JOHN ST STE M-283",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075382",
            "telephone_number": "269-349-7696"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 E Mansion St",
            "address_2": "Suite 3E",
            "address_purpose": "LOCATION",
            "city": "Marshall",
            "state": "MI",
            "postal_code": "490681559",
            "country_code": "US",
            "telephone_number": "269-781-4267",
            "fax_number": "269-781-2710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "ANDREW",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD, FACS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "AG067751",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301067751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4227783",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4848964",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM GROUP ID",
            "identifier": "020A312720",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.