NPIMap

Individual provider Active NPI

Clara Gordon, PA-C

  • Physician Assistant
  • Truckee, CA
National Provider Identifier
1538436670
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA52487 Issued in CA
Practice address
10121 Pine Ave
Truckee, CA 96161-4856
Phone
(530) 587-6011
NPI assigned
Nov 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2351 NV
Physician Assistant 363A00000X PA2308 ME
Registered Dietitian 133V00000X 1102870 MA
Physician Assistant 363A00000X PA52487 CA Primary

Addresses

Primary practice location

10121 Pine Ave
Truckee, CA 96161-4856

Mailing address

PO Box 1460
Truckee, CA 96160-1460
Phone (207) 577-1809

Other practice location 1

10051 Lake Ave Ste 3
Truckee, CA 96161-4870
Phone (530) 587-7461

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160520000621 CA Practitioner - Physician Assistant 7719288588 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1102870MAMDRegistered Dietitian
PA52487CAMDPhysician Assistant
PA2351NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tahoe Forest Hospital District CurrentSince Jul 1, 2020 Accepting new patients
Orthonorcal Inc CurrentSince Apr 9, 2016 Accepting new patients
Tahoe Forest Hospital District CurrentSince Jul 1, 2020 Accepting new patients
Tahoe Forest Hospital District Past Accepting new patients

Locations

340 Dardanelli Ln
Ste 10
Los Gatos, CA 95032
Phone (408) 412-8100

10051 Lake Ave
Ste 3
Truckee, CA 96161
Phone (530) 587-7461

10121 Pine Ave
Truckee, CA 96161
Phone (530) 582-3220

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 1

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

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Tufts University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tahoe Forest Hospital District 140 clinicians

Practice addresses (Care Compare)

10051 Lake Ave
Suite 3
Truckee, CA 96161-4870
Phone (530) 587-7461

10121 Pine Ave
Truckee, CA 96161-4835
Phone (530) 587-6011

Hospital & facility affiliations

  • Tahoe Forest Hospital Hospital, Truckee, CA, CCN 051328

Merit-based Incentive Payment System (MIPS)

Final score
75.06 of 100Reported as group
Quality
83.97
Promoting interoperability
88
Improvement activities
40
Cost
42.89

NPI Registry JSON

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

{
    "created_epoch": "1321488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1538436670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1460",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961601460",
            "telephone_number": "207-577-1809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10121 PINE AVE",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961614856",
            "telephone_number": "530-587-6011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10051 Lake Ave Ste 3",
            "address_purpose": "LOCATION",
            "city": "Truckee",
            "state": "CA",
            "postal_code": "961614870",
            "country_code": "US",
            "telephone_number": "530-587-7461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "CLARA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-17",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2351",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA2308",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "1102870",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA52487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Truckee, CA

Sources for this page

Verify at the official NPI Registry.