Michael Justin Gorman, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO1423 Issued in NV

Practice address

10521 Jeffreys St Ste 100
Henderson, NV 89052-4181

Phone

(702) 269-6345

Fax

(702) 269-9422

NPI assigned

Aug 2, 2005

Last updated

Apr 6, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NV

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

Specialty

Family Practice

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Intermountain Medical Holdings Nevada IncGroup PAC ID 7416054622, 311 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michael.gorman@56434976161796.direct.elationemr.com
• Direct secure messaging: michaelgorman@hcpnv.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Intermountain Medical Holdings Nevada Inc

  dba Intermountain Health

  • Internal Medicine Physician
  • Henderson, NV
  • NPI 1245997279

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Intermountain Medical Holdings Nevada Inc

  dba Intermountain Health Home Care

  • Home Health Agency
  • Las Vegas, NV
  • NPI 1689882557
  NPD
• Alfaro LTD

  dba Mesa View Medical Group

  • Surgery Physician
  • Mesquite, NV
  • NPI 1467787192
  NPD (past)
• Community Medical Group, LLC

  dba Community Care of the Grand Valley

  • Family Medicine Physician
  • Grand Junction, CO
  • NPI 1629201637
  NPD (past)

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1356342364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6355 S BUFFALO DR FL 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132133",
            "telephone_number": "702-216-3346",
            "fax_number": "702-671-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10521 JEFFREYS ST STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524181",
            "telephone_number": "702-269-6345",
            "fax_number": "702-269-9422"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 Bertha Howe Ave",
            "address_2": "Suite 1",
            "address_purpose": "LOCATION",
            "city": "Mesquite",
            "state": "NV",
            "postal_code": "890277502",
            "country_code": "US",
            "telephone_number": "702-346-0800",
            "fax_number": "702-346-0801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORMAN",
        "first_name": "MICHAEL",
        "middle_name": "JUSTIN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "38165",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "DO1423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356342364",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "DO1423",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Ann Gordon
• Loida Gordon
• Nicole Gordon
• Theresa Elizabeth Gordon, APRN
• Marina Iurevna Goriainova, RN
• Harout V Gostanian, D.D.S,M.S.D
• David S Gothelf, D.O.
• Clinton Thomas Gott, M.D.
• Stephanie Goyet Wayerski
• Janel Marie Bersamina Gozum

• Family Medicine Physician in Henderson, NV
• Providers in Henderson, NV by specialty
• Family Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; 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.
• 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.