Individual provider Active NPI

Rita Gordon, CNM

  • Advanced Practice Midwife
  • Santa Monica, CA
National Provider Identifier
1477923076
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
236078 Issued in CA
Practice address
1245 16TH St Ste 312
Santa Monica, CA 90404-1239
Phone
(310) 794-7274
NPI assigned
Sep 25, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X F001714 NY
Advanced Practice Midwife 367A00000X
Advanced Practice Midwife 367A00000X 236078 CA Primary

Addresses

Primary practice location

1245 16TH St Ste 312
Santa Monica, CA 90404-1239

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (310) 301-8707

Other practice location 1

9004 161st St
Jamaica, NY 11432-6141
Phone (718) 523-2123

Other identifiers 1

IdentifierTypeStateIssuer
00695941MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160509001539 NY Practitioner - Certified Nurse Midwife (CNM) 2860791134 Reassigns benefits to 1 organization
I20220331001697 CA Practitioner - Certified Nurse Midwife (CNM) 2860791134 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
001714NYMDAcupuncturist
F001714NYMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
Jamaica Hospital CurrentSince Mar 1, 2016 Accepting new patients
Jamaica Hospital CurrentSince Mar 1, 2016 Accepting new patients
The Regents of the University of California CurrentSince May 1, 2022 Accepting new patients
The Regents of the University of California Past Accepting new patients
Community Healthcare Network, Inc. Past Accepting new patients
Community Healthcare Network Inc Past Accepting new patients
Jamaica Hospital Nursing Home Co Inc Past Accepting new patients
UCLA Medical Group Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients

Locations

File 54456
Los Angeles, CA 90074

1010 Veteran Ave
Los Angeles, CA 90024
Phone (310) 825-7955

200 Medical Plz
Ste 430
Los Angeles, CA 90095
Phone (310) 794-8282

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

1245 16th St
Ste 312
Santa Monica, CA 90404
Phone (310) 453-1982

2001 Santa Monica Blvd
Ste 380
Santa Monica, CA 90404
Phone (310) 899-7500

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

Interoperability endpoints

  • Direct secure messaging: rita.gordon@chn.eclinicaldirectplus.com
  • Direct secure messaging: rgordon989824@direct.uclahealth.org

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1443139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1477923076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-8707",
            "fax_number": "646-312-0481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 16TH ST STE 312",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041239",
            "telephone_number": "310-794-7274"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9004 161st St",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "114326141",
            "country_code": "US",
            "telephone_number": "718-523-2123",
            "fax_number": "718-523-5833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "RITA",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-25",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "NY",
            "license": "F001714",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "236078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00695941",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.