Individual provider Active NPI

Robert Gordon, M.D.

  • Specialist
  • Westminster, MD
National Provider Identifier
1225021546
Registry record updated Oct 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
D20554 Issued in MD
Practice address
826 Washington Rd
Suite 209
Westminster, MD 21157-5750
Phone
(410) 840-8203
Fax
(410) 751-2816
NPI assigned
Aug 23, 2005
Last updated
Oct 6, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X D20554 MD Primary

Addresses

Primary practice location

826 Washington Rd
Suite 209
Westminster, MD 21157-5750

Mailing address

826 Washington Rd
Suite 209
Westminster, MD 21157-5750
Phone (410) 840-8203

Other identifiers 1

IdentifierTypeStateIssuer
309904100MedicaidMD

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20111208000361 MD Practitioner - Thoracic SurgeryPractitioner - Vascular Surgery 6204001936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic SurgeryAlso: Vascular Surgery
Education
Tufts University School of Medicine, 1966
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vascular and Cardiothoracic Associates of Maryland PAGroup PAC ID 1254340474, 2 clinicians

Practice addresses (Care Compare)

826 Washington Rd
Westminster, MD 21157-5780
Phone (410) 840-8203

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vascular and Cardiothoracic Associates of Maryland PA Specialist CurrentSince Jul 1, 1998 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

826 Washington Rd
Ste 209
Westminster, MD 21157
Phone (410) 486-5901

Interoperability endpoints

  • Direct secure messaging: robert.gordon@vacaomp-md.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 2

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 1

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": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317859200000",
    "number": "1225021546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 WASHINGTON RD",
            "address_2": "SUITE 209",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575750",
            "telephone_number": "410-840-8203",
            "fax_number": "410-751-2816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 WASHINGTON RD",
            "address_2": "SUITE 209",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575750",
            "telephone_number": "410-840-8203",
            "fax_number": "410-751-2816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "ROBERT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2011-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "D20554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "309904100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, MD

Sources for this page

Verify at the official NPI Registry.