Individual provider Active NPI

Martin N Gordon, M.D.

  • Pulmonary Disease Physician
  • Beverly Hills, CA
National Provider Identifier
1447353313
Registry record updated Jul 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
G31316 Issued in CA
Practice address
9401 Wilshire Blvd
Suite 515
Beverly Hills, CA 90212-2928
Phone
(310) 432-4260
NPI assigned
Sep 6, 2006
Last updated
Jul 13, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X G31316 CA Primary

Addresses

Primary practice location

9401 Wilshire Blvd
Suite 515
Beverly Hills, CA 90212-2928

Mailing address

9401 Wilshire Blvd
Suite 515
Beverly Hills, CA 90212-2928
Phone (310) 432-4260

Other identifiers 1

IdentifierTypeStateIssuer
00G313160MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20060105000407 CA Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 1153344148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Icahn School of Medicine at Mount Sinai, 1973
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

9401 Wilshire Blvd
Suite 515
Beverly Hills, CA 90212-2947
Phone (310) 432-4260

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G31316CAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Martin N Gordon MD Pulmonary Disease CurrentSince Jan 1, 2006 Accepting new patients
Martin N Gordon MD Pulmonary Disease Current Accepting new patients

Locations

9001 Wilshire Blvd
Ste 307
Beverly Hills, CA 90211
Phone (310) 275-1724

9401 Wilshire Blvd
Ste 515
Beverly Hills, CA 90212
Phone (310) 432-4260

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436745600000",
    "number": "1447353313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9401 WILSHIRE BLVD",
            "address_2": "SUITE 515",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902122928",
            "telephone_number": "310-432-4260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9401 WILSHIRE BLVD",
            "address_2": "SUITE 515",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902122928",
            "telephone_number": "310-432-4260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "MARTIN",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2015-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "G31316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G313160",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.