Randall Stuart Gordon, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OS008913L Issued in PA

Practice address

800 Spruce Street
Pine 1 West
Philadelphia, PA 19107-6130

Phone

(215) 829-7817

Fax

(215) 829-7129

NPI assigned

Aug 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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

HospitalistAlso: Internal Medicine

Education

Nova Southeastern College of Osteo Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clinical Care Associates of the University of Pennsylvania Health.Group PAC ID 4688588866, 591 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pennsylvania Hospital Hospital, Philadelphia, PA, CCN 390226

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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

• Clinical Care Associates of the University of Pennsylvania Health

  • Internal Medicine Physician
  • Radnor, PA
  • NPI 1972682995
  Medicare reassignment Care Compare group NPD
• Clinical Care Associates of the University of Pennsylvania Health

  • Psychologist
  • West Chester, PA
  • NPI 1649940107
  NPD
• Clinical Care Associates of the University of Pennsylvania Health Syst

  • Hospitalist Physician
  • Bala Cynwyd, PA
  • NPI 1790737468

  Internal Medicine

  NPD
• The Pennsylvania Hospital of the University of Pennsylvania Health Sys

  • General Acute Care Hospital
  • Phila, PA
  • NPI 1063489342
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Pennsylvania Hospital of the University of Pennsylvania Health Sys

  • General Acute Care Hospital
  • Phila, PA
  • NPI 1063489342
  Care Compare affiliation

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336608000000",
    "number": "1407964299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SPRUCE STREET",
            "address_2": "PINE 1 WEST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076130",
            "telephone_number": "215-829-7817",
            "fax_number": "215-829-7129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SPRUCE STREET",
            "address_2": "PINE 1 WEST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076130",
            "telephone_number": "215-829-7817",
            "fax_number": "215-829-7129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "RANDALL",
        "middle_name": "STUART",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2012-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS008913L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019158670002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monique Gordon
• Nancy D Gordon, M.D.
• Natika Jasmine Gordon, BS
• Nickita Gordon
• Rachel Erica Gordon
• Rex Gordon III, PHARM. D.
• Robert Michael Gordon, DO
• Ryan Gordon, PHARM D.
• Sarah Hope Gordon, CRNP
• Scott Michael Gordon, M.D., PH.D.

• Internal Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2012; 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.