Individual provider Active NPI

Elisabeth Groome Gordon, M.D.

  • Psychiatry Physician
  • Stanfordville, NY
National Provider Identifier
1245495795
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
254142 Issued in NY
Practice address
181 Shelley Hill Rd
Stanfordville, NY 12581-6054
Phone
(917) 655-1669
Fax
(917) 460-0154
NPI assigned
Jul 24, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 254142 NY Primary

Addresses

Primary practice location

181 Shelley Hill Rd
Stanfordville, NY 12581-6054

Mailing address

181 Shelley Hill Rd
Stanfordville, NY 12581-6054
Phone (917) 655-1669

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1216857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1245495795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 SHELLEY HILL RD",
            "city": "STANFORDVILLE",
            "state": "NY",
            "postal_code": "125816054",
            "telephone_number": "917-655-1669",
            "fax_number": "917-460-0154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 SHELLEY HILL RD",
            "city": "STANFORDVILLE",
            "state": "NY",
            "postal_code": "125816054",
            "telephone_number": "917-655-1669",
            "fax_number": "917-460-0154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "ELISABETH",
        "middle_name": "GROOME",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-24",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "254142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanfordville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.