Organization Active NPI

David a Gordon PC

  • Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
  • Lutherville, MD
National Provider Identifier
1235590357
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Urology) PhysicianTaxonomy code 2088F0040X
Legal business name
DAVID A GORDON PC
Practice address
1447 York Rd
Suite 406
Lutherville, MD 21093-6017
Phone
(410) 343-3001
Fax
(410) 823-0015
NPI assigned
Mar 17, 2016
Last updated
Jul 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Authorized official

Name
Tracy McCartin
Title
Administrator
Phone
(410) 343-3001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician 2088F0040X Primary

Addresses

Primary practice location

1447 York Rd
Suite 406
Lutherville, MD 21093-6017

Mailing address

1447 York Rd Ste 406
Lutherville, MD 21093-6057
Phone (410) 343-3001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160817002124 MD Part B Supplier - Clinic/Group Practice 8729373691 Receives reassigned benefits from 2 practitioners
Practice locations: Lutherville, MD
O20191223000210 DC Part B Supplier - Clinic/Group Practice 8729373691 Receives reassigned benefits from 2 practitioners
Practice locations: Landover, MD

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2118388David a Gordon PC1447 York Road #406, Lutherville, MD 21093ComplianceMar 3, 2028

National Provider Directory

National Provider Directory

Locations

1015 Prince Frederick Blvd
Prince Frederick, MD 20678
Phone (410) 231-4666

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1458172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689552000000",
    "number": "1235590357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1447 YORK RD STE 406",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936057",
            "telephone_number": "410-343-3001",
            "fax_number": "410-823-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1447 YORK RD",
            "address_2": "SUITE 406",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936017",
            "telephone_number": "410-343-3001",
            "fax_number": "410-823-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID A GORDON PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A",
        "authorized_official_last_name": "MCCARTIN",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "410-343-3001"
    },
    "taxonomies": [
        {
            "code": "2088F0040X",
            "taxonomy_group": "",
            "desc": "Urology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutherville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.