Gordon Lucas Fifer, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

ME156455 Issued in FL

Practice address

240 Southpark Cir E
Saint Augustine, FL 32086-5137

Phone

(904) 824-1450

NPI assigned

Feb 13, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in FL, OH2 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 2

Specialty

Urology

Education

Medical College of Ohio, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Urology Institute LLCGroup PAC ID 2163653585, 152 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Flagler Hospital Hospital, Saint Augustine, FL, CCN 100090
• Brooks Rehabilitation Hospital University Campus Inpatient rehabilitation facility, Jacksonville, FL, CCN 103039

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/uc41222_advuroswflorida
• Direct secure messaging: gordonfifer@aui.medalliesdirect.net
• Direct secure messaging: gfifer744665@direct.shands.ufl.edu

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.

• Advanced Urology Institute, LLC

  • Urology Physician
  • Oxford, FL
  • NPI 1023447935
  Medicare reassignment Care Compare group NPD
• Kettering Independent Medical Group Inc

  • Orthopaedic Surgery Physician
  • Miamisburg, OH
  • NPI 1629387865
  Medicare reassignment NPD
• Advanced Urology Institute, LLC

  • Durable Medical Equipment & Medical Supplies
  • Inverness, FL
  • NPI 1700024163

  Urology

  NPD
• Advanced Urology Institute LLC

  • Non-Pharmacy Dispensing Site
  • Orange City, FL
  • NPI 1831310507

  Urology

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Flagler Hospital Inc

  • General Acute Care Hospital
  • St Augustine, FL
  • NPI 1144211020
  Care Compare affiliation
• Flagler Hospital, Inc.

  • Urgent Care Clinic/Center
  • Saint Augustine, FL
  • NPI 1447527965

  Hospital

  Care Compare affiliation
• Genesis Rehabilitation Hospital, Inc.

  • Rehabilitation Hospital
  • Jacksonville, FL
  • NPI 1376114413

  Inpatient rehabilitation facility

  Care Compare affiliation
• Genesis Rehabilitation Hospital, Inc.

  • Rehabilitation Hospital
  • Jacksonville, FL
  • NPI 1912947748

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1497729933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12109 COUNTY ROAD 103",
            "city": "OXFORD",
            "state": "FL",
            "postal_code": "344842951",
            "telephone_number": "352-205-8981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 SOUTHPARK CIR E",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320865137",
            "telephone_number": "904-824-1450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 Miamisburg Centerville Rd Ste 450",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453423908",
            "country_code": "US",
            "telephone_number": "937-560-2011",
            "fax_number": "937-560-2012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FIFER",
        "first_name": "GORDON",
        "middle_name": "LUCAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OH",
            "license": "35.151509",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME156455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gfifer917716@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "4000 Miamisburg Centerville Rd Ste 450",
            "city": "Miamisburg",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453423908",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "4000 Miamisburg Centerville Rd Ste 450",
            "city": "Miamisburg",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453423908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Adrienne V Fetner
• Ana Fezollari
• Mackenzie Fezza
• Fife Integrative Health PA
• Toni J Fife
• Fifty Seven Consulting LLC
• Lois Jeanette Fincher, PA-C
• Mia Finger, MS, RDN, LD
• Douglas Fiorentino, DPT
• Ashley Firrantello

• Urology Physician in Saint Augustine, FL
• Providers in Saint Augustine, FL by specialty
• Urology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.