Individual provider Active NPI

Alan N Gordon, O.D.

  • Sports Vision Optometrist
  • Munster, IN
National Provider Identifier
1407846645
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Vision OptometristTaxonomy code 152WS0006X
License
18001595B Issued in IN
Practice address
1650 45TH Ave
Suite I
Munster, IN 46321-3962
Phone
(219) 924-8012
Fax
(219) 924-8170
NPI assigned
Oct 27, 2005
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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 18001595B IN
Pediatric Optometrist 152WP0200X 18001595B IN
Sports Vision Optometrist 152WS0006X 18001595B IN Primary
Occupational Vision Optometrist 152WX0102X 18001595B IN

Addresses

Primary practice location

1650 45TH Ave
Suite I
Munster, IN 46321-3962

Mailing address

1650 45TH Ave
Suite I
Munster, IN 46321-3962
Phone (219) 924-8012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18001595BINMDCorneal and Contact Management Optometrist

NPI Registry JSON

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1407846645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 45TH AVE",
            "address_2": "SUITE I",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463213962",
            "telephone_number": "219-924-8012",
            "fax_number": "219-924-8170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 45TH AVE",
            "address_2": "SUITE I",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463213962",
            "telephone_number": "219-924-8012",
            "fax_number": "219-924-8170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "ALAN",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "IN",
            "license": "18001595B",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "IN",
            "license": "18001595B",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "IN",
            "license": "18001595B",
            "primary": true
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "IN",
            "license": "18001595B",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.