NPIMap

Individual provider Active NPI

Gary Gordon, M.D.

  • Rheumatology Physician
  • Wynnewood, PA
National Provider Identifier
1225065774
Registry record updated Nov 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
MD017706E Issued in PA
Practice address
100 E Lancaster Ave
Suite 137 Lankenau Medical BLDG.
Wynnewood, PA 19096-3450
Phone
(610) 896-8400
Fax
(610) 896-9652
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X MD017706E PA Primary

Addresses

Primary practice location

100 E Lancaster Ave
Suite 137 Lankenau Medical BLDG.
Wynnewood, PA 19096-3450

Mailing address

100 Lancaster Avenue
Suite 137
Wynnewood, PA 19096
Phone (610) 896-8400

Other identifiers 1

IdentifierTypeStateIssuer
11966MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20101104001345 PA Practitioner - Rheumatology 1456450725 Reassigns benefits to 1 organization
Receives reassigned benefits from 6 practitioners
Practice locations: Wynnewood, PA

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Yale University School of Medicine, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bryn Mawr Medical Specialists AssociationGroup PAC ID 4183610934, 135 clinicians

Practice addresses (Care Compare)

825 Old Lancaster Rd
Suite 320
Bryn Mawr, PA 19010-3235
Phone (610) 527-3800

Hospital & facility affiliations

  • Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195
  • Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139
  • Paoli Hospital Hospital, Paoli, PA, CCN 390153
  • Riddle Memorial Hospital Hospital, Media, PA, CCN 390222
  • Chester County Hospital Hospital, West Chester, PA, CCN 390179

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bryn Mawr Medical Specialists Association CurrentSince Jan 1, 2021 Accepting new patients
Gary Gordon Rheumatology PastSince Dec 4, 1978 Accepting new patients

Locations

1991 Sproul Rd
Ste 300A
Broomall, PA 19008
Phone (610) 353-5079

825 Old Lancaster Rd
Ste 320
Bryn Mawr, PA 19010
Phone (610) 524-3800

100 E Lancaster Ave
Ste 137
Wynnewood, PA 19096
Phone (610) 896-8400

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

Interoperability endpoints

  • Direct secure messaging: gary.gordon@bmmsa.directbygreenway.com

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351814400000",
    "number": "1225065774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 LANCASTER AVENUE",
            "address_2": "SUITE 137",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "19096",
            "telephone_number": "610-896-8400",
            "fax_number": "610-896-9652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "address_2": "SUITE 137 LANKENAU MEDICAL BLDG.",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "610-896-8400",
            "fax_number": "610-896-9652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "GARY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2012-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "PA",
            "license": "MD017706E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11966",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

Verify at the official NPI Registry.