Peter M Gordon, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

15530 Issued in NE

Practice address

111 S 90TH St
Omaha, NE 68114-3907

Phone

(402) 397-9800

Fax

(402) 397-7591

NPI assigned

May 23, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NE

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Unmc Physicians

  • Multi-Specialty Clinic/Center
  • Omaha, NE
  • NPI 1417912114
  Medicare reassignment NPD

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1225031479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S 90TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143907",
            "telephone_number": "402-397-9800",
            "fax_number": "402-397-7591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 90TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143907",
            "telephone_number": "402-397-9800",
            "fax_number": "402-397-7591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "PETER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NE",
            "license": "15530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09883700",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Schmadeke Gordon, DDS
• Leonard Ray Gordon
• Madeline Lorraine Gordon
• Marvis Gordon
• Mary Elizabeth Gordon, SLP
• Sherrie Thompson Gordon, D.C.
• Terrence Gordon
• Caitlyn Gore
• Michael P Gorga, PH.D.
• Wendy Gorham

• Urology Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Urology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.