Meredith Leigh Fishbane Gordon, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD-41814 Issued in IA

Practice address

1130 S Scott Blvd
Uicms Southeast Clinic - General Pediatrics
Iowa City, IA 52240-2907

Phone

(319) 467-6789

NPI assigned

May 19, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Meredith Leigh Fishbane Former name

Medicare fee-for-service enrollment

Enrolled in IA

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

Pediatric Medicine

Education

University of Chicago, Pritzker School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

State University of IowaGroup PAC ID 7618884230, 1,886 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mfishbanegordon67069@uihcdirect.org

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.

• State University of Iowa

  • Family Medicine Physician
  • Iowa City, IA
  • NPI 1477554814

  Pediatrics

  Medicare reassignment Care Compare group NPD
• State University of Iowa

  • Family Medicine Physician
  • Iowa City, IA
  • NPI 1730138579
  NPD
• State University of Iowa

  • Student Health Clinic/Center
  • Iowa City, IA
  • NPI 1285635664
  NPD (past)

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

{
    "created_epoch": "1179532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428451200000",
    "number": "1417165614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 S SCOTT BLVD",
            "address_2": "UICMS SOUTHEAST CLINIC - GENERAL PEDIATRICS",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522402907",
            "telephone_number": "319-467-6789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 S SCOTT BLVD",
            "address_2": "UICMS SOUTHEAST CLINIC - GENERAL PEDIATRICS",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522402907",
            "telephone_number": "319-467-6789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHBANE GORDON",
        "first_name": "MEREDITH",
        "middle_name": "LEIGH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-19",
        "last_updated": "2015-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "231765",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD429411",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "MD-41814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEREDITH",
            "last_name": "FISHBANE",
            "middle_name": "LEIGH",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• First Resources Corp
• Anthony John Fischer, M.D.
• Friederike Fischer, M.D.
• Julie Marie Fischer, MD
• Seth James Fiscus, PHARMD
• Janice Ann Fisher, RD, LD, PHD, CDE
• Janita J Fisher
• Laura Marie Fisher, CCC-SLP
• Lorin Fisher, PHARMD
• Mark Daniel Fisher, M.D.

• Pediatrics Physician in Iowa City, IA
• Providers in Iowa City, IA by specialty
• Pediatrics Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2015; 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.