Active NPI
David a Gordon PC
- Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
- Lutherville, MD
National Provider Identifier
1235590357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
- 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, 2023
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, DC
Enrollment records 2
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 21D2118388 | David a Gordon PC | Compliance | Mar 3, 2028 |
National Provider Directory
National Provider DirectoryLocations
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.