Mark William Gordon, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME13633 Issued in FL

Practice address

7100 W 20TH Ave
#703
Hialeah, FL 33016-1897

Phone

(305) 822-4515

Fax

(954) 963-3453

NPI assigned

Oct 20, 2005

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 FL

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

General SurgeryAlso: Colorectal Surgery (Proctology)

Education

Other, 1967

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vitalmd Group Holding LLCGroup PAC ID 8921091786, 535 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Vitalmd Group Holding LLC

  • Obstetrics & Gynecology Physician
  • Miami, FL
  • NPI 1871572032

  Surgery

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1467441618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 N UNIVERSITY DR",
            "address_2": "#203",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330243617",
            "telephone_number": "954-964-1490",
            "fax_number": "954-963-3453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 W 20TH AVE",
            "address_2": "#703",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330161897",
            "telephone_number": "305-822-4515",
            "fax_number": "954-963-3453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME13633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "056068500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yiret Gordillo Lopez
• Mayvit Gordillo
• Miguel Angel Gordillo, D.P.M.
• Gordis General Services LLC
• Gordon Clinic-Antonio Gordon MD PA
• Barbara Gorra Gonzalez
• Maanvita Krishna Gorrepati, DO
• Yaneli Gorrita Alejo
• Yusleidys Gorrita Brito
• Yelina Gorrita Perez

• Surgery Physician in Hialeah, FL
• Providers in Hialeah, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.