Phyllis Lynn Gordon, M.S.O.T.R.

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

License

TR00810 Issued in NJ

Practice address

10 Byrne LN
Tenafly, NJ 07670-2707

Phone

(201) 569-6288

Fax

(201) 227-9267

NPI assigned

Mar 24, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Columbia University College of Physicians and Surgeons, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1237852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282176000000",
    "number": "1285876128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 BYRNE LN",
            "city": "TENAFLY",
            "state": "NJ",
            "postal_code": "076702707",
            "telephone_number": "201-569-6288",
            "fax_number": "201-227-9267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 BYRNE LN",
            "city": "TENAFLY",
            "state": "NJ",
            "postal_code": "076702707",
            "telephone_number": "201-569-6288",
            "fax_number": "201-227-9267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "PHYLLIS",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "M.S.O.T.R.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-24",
        "last_updated": "2010-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XM0800X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Mental Health",
            "state": "NJ",
            "license": "TR00810",
            "primary": false
        },
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "NJ",
            "license": "TR00810",
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "NJ",
            "license": "TR00810",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NJ",
            "license": "TR00810",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan Gobioff
• Thomas Hugh Golden, PH.D.
• Jeffrey P Goldman, MD
• Good Mental Health PC
• Daniel Joshua Gordon, OD
• Erin Graskemper, LMT
• Michaela Esther Greenbaum, MD
• Robert John Greenstein, MD
• Roswitha R Grogan, M.ED.
• Carey Ellen Gross, MD

• Physical Rehabilitation Occupational Therapist in Tenafly, NJ
• Providers in Tenafly, NJ by specialty
• Physical Rehabilitation Occupational Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2010; 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.