Active NPI
Kyle Patrick Gordley, M.D.
- Plastic and Reconstructive Surgery Physician
- Shenandoah, TX
National Provider Identifier
1437328002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic and Reconstructive Surgery Physician
- License
- M7222
- Practice address
- 129 Vision Park Blvd Ste 210
Shenandoah, TX 77384-3024 - Phone
- (832) 813-5839
- Fax
- (832) 813-8512
- NPI assigned
- Feb 27, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic and Reconstructive Surgery Physician | 2086S0122X | M7222 | TX | Primary |
Addresses
Primary practice location
129 Vision Park Blvd Ste 210
Shenandoah, TX 77384-3024
Mailing address
129 Vision Park Blvd Ste 210
Shenandoah, TX 77384-3024
Phone (832) 813-5839
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8BD300 | Other | TX | BC/BS |
| 336662701 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Plastic and Reconstructive Surgery
- Education
- University of Texas Southwestern Medical School at Dallas, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
129 Vision Park Blvd
Suite 210
Shenandoah, TX 77384-3024
Phone (832) 813-5839
Hospital & facility affiliations
- Memorial Hermann Hospital System
- Tops Surgical Specialty Hospital
- Houston Methodist the Woodlands Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Mastectomy | 14 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M7222 | TX | MD | Plastic and Reconstructive Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gordley Plastic Surgery PA | Plastic and Reconstructive Surgery | Current | Accepting new patients |
Locations
129 Vision Park Blvd
Ste 210
Shenandoah, TX 77384
Phone (832) 813-5839
Interoperability endpoints
- kgordley@direct.uspi.com
Organizations & group practices 1
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.
-
- Plastic and Reconstructive Surgery Physician
- Shenandoah, TX
- NPI 1083885891
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Houston, TX
- NPI 1730132234
-
- General Acute Care Hospital
- The Woodlands, TX
- NPI 1184179194
-
- General Acute Care Hospital
- Houston, TX
- NPI 1144203662
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597104000000",
"number": "1437328002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "129 VISION PARK BLVD STE 210",
"city": "SHENANDOAH",
"state": "TX",
"postal_code": "773843024",
"telephone_number": "832-813-5839",
"fax_number": "832-813-8512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "129 VISION PARK BLVD STE 210",
"city": "SHENANDOAH",
"state": "TX",
"postal_code": "773843024",
"telephone_number": "832-813-5839",
"fax_number": "832-813-8512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDLEY",
"first_name": "KYLE",
"middle_name": "PATRICK",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-02-27",
"last_updated": "2020-08-11",
"certification_date": "2020-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0122X",
"taxonomy_group": "",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "TX",
"license": "M7222",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "8BD300",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "336662701",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shenandoah, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; 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.