Bradley Jennings Gordon, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036-069850 Issued in IL

Practice address

850 W Irving Park Rd Ste 1
Chicago, IL 60613-3099

Phone

(773) 975-6775

Fax

(847) 433-8294

NPI assigned

Oct 24, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

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

Psychiatry

Education

Other, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Thorek Memorial HospitalGroup PAC ID 4981593399, 49 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Thorek Memorial Hospital Hospital, Chicago, IL, CCN 140115

Merit-based Incentive Payment System (MIPS)

Final score

81.04 of 100Reported as group

Quality

53.2

Promoting interoperability

89

Improvement activities

40

Cost

76.1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Thorek Memorial Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1982643961
  Medicare reassignment Care Compare group NPD
• Thorek Hospital and Medical Center Outpatient Pharmacy

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1619178720
  NPD
• Thorek Memorial Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1891755351
  NPD
• Thorek Radiology Group NFP

  • Diagnostic Radiology Physician
  • Chicago, IL
  • NPI 1588261978
  NPD
• Presence Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Melrose Park, IL
  • NPI 1477622298
  NPD (past)
• Shifa Nephrology Associates LLC

  • Nephrology Physician
  • Chicago, IL
  • NPI 1487955878
  NPD (past)

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

• Thorek Memorial Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1982643961
  Care Compare affiliation

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1457435786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14537",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606140537",
            "telephone_number": "847-433-8297",
            "fax_number": "847-433-8294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 W IRVING PARK RD STE 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606133099",
            "telephone_number": "773-975-6775",
            "fax_number": "847-433-8294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 N Lake Shore Dr",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606576274",
            "country_code": "US",
            "telephone_number": "773-665-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "BRADLEY",
        "middle_name": "JENNINGS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036-069850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036069850",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "31603528",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anne M Gordon
• Ashley Gordon
• Ayo Henry Gordon, D.C.
• Barbara Jean Gordon, MSN
• Barbara P Gordon
• Brenda Jo Gordon, DDS
• Colette Gordon, MD
• Daniel Adam Gordon, LCSW
• Darwin Gordon
• Dawnelle Marie-Vargas Gordon, PMHNP-BC, ARNP, APNP

• Psychiatry Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.

Verify at the official NPI Registry.