Bruce Roderick Gordon, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

47040 Issued in MA

Practice address

65 Cedar St
Hyannis, MA 02601-3009

Phone

(508) 790-0611

Fax

(508) 790-0589

NPI assigned

Sep 6, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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

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.

• Medical Affiliates of Cape Cod, Inc.

  • Internal Medicine Physician
  • Hyannis, MA
  • NPI 1770534927
  Medicare reassignment NPD
• Medical Affiliates of Cape Cod, Inc.

  • Ambulatory Surgical Clinic/Center
  • Mashpee, MA
  • NPI 1306391206
  NPD

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323388800000",
    "number": "1467446542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 CEDAR ST",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026013009",
            "telephone_number": "508-790-0611",
            "fax_number": "508-790-0589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 CEDAR ST",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026013009",
            "telephone_number": "508-790-0611",
            "fax_number": "508-790-0589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "BRUCE",
        "middle_name": "RODERICK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-06",
        "last_updated": "2011-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MA",
            "license": "47040",
            "primary": true
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "MA",
            "license": "47040",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0142514",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaclyn Gonsalves
• Rosemary Gonzalez
• Earl Anthony Gooden, MD
• Isaac Goodman, PA-C
• Wade Thomas Goolishian, MD
• Daniel R Gorin, MD
• Nirmal Rajendra Gosalia, MD
• Jennifer Gounaris, RN
• Cherie M Gravelle-Stulsky, MSW
• Greater Boston Allergy Asthma Sinus & Immunology Centers, P.C.

• Otolaryngology Physician in Hyannis, MA
• Providers in Hyannis, MA by specialty
• Otolaryngology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.