Individual provider Active NPI

Michael B Gordon, OD

  • Optometrist
  • Peterborough, NH
National Provider Identifier
1265433429
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
530 Issued in NH
Practice address
9 Main St
Peterborough, NH 03458-2417
Phone
(603) 924-1611
Fax
(603) 924-1609
NPI assigned
Aug 9, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 530 NH Primary

Addresses

Primary practice location

9 Main St
Peterborough, NH 03458-2417

Mailing address

9 Main St
Peterborough, NH 03458-2417
Phone (603) 924-1611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051101000954 NH Practitioner - Optometry 8325065022 Practice locations: Peterborough, NH

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9 Main St
Peterborough, NH 03458-2417
Phone (603) 924-1611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
530NHMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1265433429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 MAIN ST",
            "city": "PETERBOROUGH",
            "state": "NH",
            "postal_code": "034582417",
            "telephone_number": "603-924-1611",
            "fax_number": "603-924-1609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 MAIN ST",
            "city": "PETERBOROUGH",
            "state": "NH",
            "postal_code": "034582417",
            "telephone_number": "603-924-1611",
            "fax_number": "603-924-1609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "MICHAEL",
        "middle_name": "B",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NH",
            "license": "530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peterborough, NH

Sources for this page

Verify at the official NPI Registry.