Dudley R Gordon, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD022169E Issued in PA

Practice address

8105 Adams Dr
Hummelstown, PA 17036-8625

Phone

(717) 652-1211

Fax

(717) 652-4948

NPI assigned

May 2, 2006

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 3

Medicare fee-for-service enrollment

Enrolled in PA

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

State licenses

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.

• Pinnacle Health Medical Services

  • Family Medicine Physician
  • Harrisburg, PA
  • NPI 1932143427
  Medicare reassignment NPD
• Pinnacle Health Medical Services

  dba UPMC Gastroenterology Associates of Central PA

  • Gastroenterology Physician
  • Mechanicsburg, PA
  • NPI 1295552073
  NPD
• Pinnacle Health Medical Services

  dba Women's Center for Bladder and Pelvic Health-UPMC

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Harrisburg, PA
  • NPI 1811407679
  NPD

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1245298074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 S 2ND ST",
            "address_2": "SUITE 2F",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041612",
            "telephone_number": "717-564-5400",
            "fax_number": "717-564-7859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8105 ADAMS DR",
            "city": "HUMMELSTOWN",
            "state": "PA",
            "postal_code": "170368625",
            "telephone_number": "717-652-1211",
            "fax_number": "717-652-4948"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2310 Patton Rd",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "PA",
            "postal_code": "171129154",
            "country_code": "US",
            "telephone_number": "717-724-6500",
            "fax_number": "717-724-6510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "DUDLEY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD022169E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009053290003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5126044",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CBC/CAIC",
            "identifier": "50070215",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Rose Goddard, OTR/L
• Michelle Godfrey
• Vidyottama Goel, M.D.
• Lynn Gomer
• Glendys Gonzalez
• Christopher Paul Gorton, M.D.
• Lori M Grafton, M.D.
• Michael Gray, PTA
• Christopher Charles Gregorich, PA-C
• Matthew Griffith, DMD

• Family Medicine Physician in Hummelstown, PA
• Providers in Hummelstown, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; 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.