Individual provider Active NPI

Gordian Ndubizu, D.O.

  • Surgery Physician
  • Hagerstown, MD
National Provider Identifier
1487016200
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
H92614 Issued in MD
Practice address
11116 Medical Campus Rd
Hagerstown, MD 21742-6710
Phone
(301) 790-8380
NPI assigned
Mar 22, 2016
Last updated
May 19, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Surgery Physician 208600000X H92614 MD Primary
Surgical Critical Care Physician 2086S0102X 1027567 MA

Addresses

Primary practice location

11116 Medical Campus Rd
Hagerstown, MD 21742-6710

Mailing address

11116 Medical Campus Rd
Hagerstown, MD 21742-6710

Other practice location 1

Geisinger Medical Center 100 North Academy Ave
Danville, PA 17822-0001
Phone (570) 271-6211

Other practice location 2

55 Lake Ave N
Worcester, MA 01655-0002
Phone (774) 475-0831

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT, NJ, MA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20231122001311 MT Practitioner - General Surgery 3476769423 Reassigns benefits to 1 organization
I20240206000166 NJ Practitioner - General Surgery 3476769423 Reassigns benefits to 2 organizations
I20260616001494 MA Practitioner - General Surgery 3476769423

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Rowan University School of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlanticare Physician Group PAGroup PAC ID 8527953660, 506 clinicians

Practice addresses (Care Compare)

1925 Pacific Ave
Atlantic City, NJ 08401-6713
Phone (609) 441-8146

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H92614MDMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanticare Physician Group, PA CurrentSince Jan 25, 2024 Accepting new patients
Atlanticare Physician Group PA Surgery CurrentSince Jan 25, 2024 Accepting new patients
Atlanticare Regional Medical Center CurrentSince Aug 15, 2025 Accepting new patients
SCL Health Medical Group-Butte LLC CurrentSince Oct 1, 2023 Accepting new patients
Atlanticare Regional Medical Center Surgery CurrentSince Aug 15, 2025 Accepting new patients
SCL Health Medical Group-Butte LLC CurrentSince Oct 1, 2023 Accepting new patients
Atlanticare Regional Medical Center Past Accepting new patients

Locations

400 S Clark St
Butte, MT 59701
Phone (406) 495-7260

435 S Crystal St
Ste 230
Butte, MT 59701
Phone (406) 723-2441

435 S Crystal St
Ste 300
Butte, MT 59701
Phone (406) 496-3600

1925 Pacific Ave
Atlantic City, NJ 08401
Phone (609) 441-8023

2500 English Creek Ave
Ste 400
Egg Hbr Twp, NJ 08234
Phone (609) 677-7700

459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815

3600 State Route 66
Fl 3
Neptune City, NJ 07753
Phone (732) 807-0463

65 W Jimmie Leeds Rd
Pomona, NJ 08240
Phone (609) 484-6414

Organizations & group practices 7

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 1

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": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1487016200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11116 MEDICAL CAMPUS RD",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11116 MEDICAL CAMPUS RD",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426710",
            "telephone_number": "301-790-8380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Geisinger Medical Center 100 North Academy Ave",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "PA",
            "postal_code": "178220001",
            "country_code": "US",
            "telephone_number": "570-271-6211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Lake Ave N",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016550002",
            "country_code": "US",
            "telephone_number": "774-475-0831",
            "fax_number": "508-856-4224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NDUBIZU",
        "first_name": "GORDIAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-22",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "H92614",
            "primary": true
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "MA",
            "license": "1027567",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.