NPIMap

Individual provider Active NPI

Marvin Isaac Gordon, M.D

  • Ophthalmology Physician
  • Lakewood, CA
National Provider Identifier
1386860575
Registry record updated Nov 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A83747 Issued in CA
Practice address
3300 E South St Ste 207
Lakewood, CA 90805-4549
Phone
(562) 602-5503
NPI assigned
Apr 17, 2007
Last updated
Nov 14, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A83747 CA Primary

Addresses

Primary practice location

3300 E South St Ste 207
Lakewood, CA 90805-4549

Mailing address

163 N Formosa Ave
Los Angeles, CA 90036-2817
Phone (310) 622-3600

Other names 1

  • Dr. M. Isaac Gordon Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, FL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050118001067 CA Practitioner - Ophthalmology 7416906342 Reassigns benefits to 1 organization
I20191216000272 FL Practitioner - Ophthalmology 7416906342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of California, San Diego School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Vision Eye Center, LLCGroup PAC ID 8123171741, 7 clinicians

Practice addresses (Care Compare)

1055 37TH PL
Vero Beach, FL 32960-6551
Phone (772) 257-8700

Merit-based Incentive Payment System (MIPS)

Final score
92.12 of 100Reported as group
Quality
99.88
Improvement activities
40
Cost
73.91

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery69

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A83747CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Vision Eye Center, LLC CurrentSince Jan 30, 2023 Accepting new patients
New Vision Surgical Center, LLC PastSince Jan 30, 2023 Accepting new patients
Valley Presbyterian Hospital PastSince Jul 24, 2018 Accepting new patients
Paul J Dougherty M D Inc Ophthalmology Past Accepting new patients
Jules Stein Eye Institute Medical Group Past Accepting new patients
Bernard Monderer, MD, Inc. Ophthalmology Past Accepting new patients
Bernard Monderer MD Ophthalmology Past Accepting new patients

Locations

1040 37th Pl
Ste 101
Vero Beach, FL 32960
Phone (772) 205-3345

1040 37th Pl
Ste 102
Vero Beach, FL 32960
Phone (561) 229-3744

Interoperability endpoints

  • Direct secure messaging: marvingordon@newvisioneyecenter.direct.eyemdemr.com

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1386860575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 N FORMOSA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900362817",
            "telephone_number": "310-622-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 E SOUTH ST STE 207",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "908054549",
            "telephone_number": "562-602-5503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "MARVIN",
        "middle_name": "ISAAC",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A83747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "M.",
            "last_name": "GORDON",
            "middle_name": "ISAAC",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Lakewood, CA

Sources for this page

Verify at the official NPI Registry.