Active NPI
Nicolas Gordon, MD
- Pulmonary Disease Physician
- New York, NY
National Provider Identifier
1306465091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- MT221413
- Practice address
- 550 1St Ave
New York, NY 10016-6402 - Phone
- (646) 929-7800
- NPI assigned
- Apr 13, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 25MA13121200 | NJ | |
| Pulmonary Disease Physician | 207RP1001X | MT221413 | NY | Primary |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 25MA13121200 | NJ |
Addresses
Primary practice location
550 1St Ave
New York, NY 10016-6402
Mailing address
353 Grove St Apt 1a
Jersey City, NJ 07302-2973
Phone (917) 474-5667
Other practice location 1
1 Springfield Ave Fl 3
Summit, NJ 07901-4055
Phone (908) 934-0555
Other practice location 2
17 Wanaque Avenue
Pompton Lakes, NJ 07442
Phone (973) 617-1750
Other practice location 3
1125 Route 22 Ste 170
Bridgewater, NJ 08807-2939
Phone (908) 947-7022
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT221413 | NY | MD | Pulmonary Disease Physician |
Interoperability endpoints
- ngordon574582@nyumc.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786406400000",
"number": "1306465091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "353 GROVE ST APT 1A",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073022973",
"telephone_number": "917-474-5667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 1ST AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100166402",
"telephone_number": "646-929-7800"
}
],
"practiceLocations": [
{
"address_1": "1 Springfield Ave Fl 3",
"address_purpose": "LOCATION",
"city": "Summit",
"state": "NJ",
"postal_code": "079014055",
"country_code": "US",
"telephone_number": "908-934-0555",
"fax_number": "908-934-0556",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "17 Wanaque Avenue",
"address_purpose": "LOCATION",
"city": "Pompton Lakes",
"state": "NJ",
"postal_code": "07442",
"country_code": "US",
"telephone_number": "973-617-1750",
"fax_number": "973-617-1751",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1125 Route 22 Ste 170",
"address_purpose": "LOCATION",
"city": "Bridgewater",
"state": "NJ",
"postal_code": "088072939",
"country_code": "US",
"telephone_number": "908-947-7022",
"fax_number": "908-947-7011",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GORDON",
"first_name": "NICOLAS",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-04-13",
"last_updated": "2026-08-11",
"certification_date": "2026-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "NJ",
"license": "25MA13121200",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "NY",
"license": "MT221413",
"primary": true
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "NJ",
"license": "25MA13121200",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; 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.