Ally Gordon, PA-C
Individual provider Active NPI Physician Assistant · Owings Mills, MD
NPI 1487832663 · NPPES record last updated Apr 29, 2014
Key facts
- NPI
- 1487832663
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- C0003380 (MD)
- Practice address
- 21 Crossroads Dr
Suite 200
Owings Mills, MD 21117-5441 - Phone
- (410) 581-1600
- NPI assigned
- Feb 10, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Chesapeake Urology Associates LLC
Practice addresses (Care Compare)
10710 Charter Dr
Suite 130
Columbia, MD 21044-3258
Phone (410) 772-7000
1838 Greene Tree Rd
Suite 460
Baltimore, MD 21208-7113
Phone (410) 581-8140
21 Crossroads Dr
Suite 200
Owings Mills, MD 21117-5483
Phone (410) 581-1600
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MD, DC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080702000631 | MD | Practitioner - Physician Assistant | 6901978170 | Reassigns benefits to 1 organization |
| I20210317000013 | DC | Practitioner - Physician Assistant | 6901978170 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chesapeake Urology Associates, LLC | Current |
Accepting new patients | |
| Chesapeake Urology Associates LLC | Current |
Accepting new patients | |
| Chesapeake Urology Associates, LLC | Current |
Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Chesapeake Urology Associates, LLC | Past | Accepting new patients |
Locations
10200 Grand Central Ave
Ste 220
Owings Mills, MD 21117
21 Crossroads Dr
Ste 200
Owings Mills, MD 21117
Phone (410) 581-8140
25 Crossroads Dr
Ste 306
Owings Mills, MD 21117
Phone (443) 231-1681
1838 Greene Tree Rd
Ste 460
Pikesville, MD 21208
Phone (410) 581-8140
3801 International Dr
Ste 310
Silver Spring, MD 20906
Phone (301) 598-9171
410 Malcolm Dr
Ste A
Westminster, MD 21157
Phone (410) 876-1633
Interoperability endpoints
- allygordon@tsicua.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | C0003380 | MD | Yes |
Addresses
Primary practice location
21 Crossroads Dr
Suite 200
Owings Mills, MD 21117-5441
Mailing address
25 Crossroads Dr
Suite 306
Owings Mills, MD 21117-5421
Phone (410) 581-1600
Other providers in Owings Mills, MD
- Skyler Dane Goodfellow
- Ketorus Gooding
- Shelly Goodling
- Kristen Dayle Goodreau
- Kenneth Marvin Goodwich
- Avi Gordon
- Jacob L. Gordon
- Priya Gordon
- Sharon Faith Gorenstein
- Tamisha Gould
All providers in Owings Mills, MD · Physician Assistant in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.