NPIMap

Individual provider Active NPI

Gordon Daniel Liss, MD

  • Gastroenterology Physician
  • Frederick, MD
National Provider Identifier
1669620746
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD0070283 Issued in MD
Practice address
310 W Ninth St
Frederick, MD 21701-4546
Phone
(301) 695-6800
Fax
(301) 695-6891
NPI assigned
Sep 3, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X C168998 CA
Gastroenterology Physician 207RG0100X MD0070283 MD Primary

Addresses

Primary practice location

310 W Ninth St
Frederick, MD 21701-4546

Mailing address

10825 Admirals Way
Potomac, MD 20854-1232

Other practice location 1

2205 Vista Way Ste 340
Oceanside, CA 92054-5661
Phone (760) 704-5870

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
I20210412002539 CA Practitioner - Gastroenterology 1153514153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Georgetown University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

2205 Vista Way
Oceanside, CA 92054-5661
Phone (858) 554-9100

Hospital & facility affiliations

  • Scripps Green Hospital Hospital, La Jolla, CA, CCN 050424
  • Scripps Memorial Hospital - Encinitas Hospital, Encinitas, CA, CCN 050503
  • Scripps Memorial Hospital la Jolla Hospital, La Jolla, CA, CCN 050324

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy107
Upper gastrointestinal (GI) endoscopy for acid reflux149

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD0070283MDMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Scripps Health CurrentSince May 3, 2021 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health CurrentSince May 3, 2021 Accepting new patients
Scripps Health Past Accepting new patients
Scripps Clinic Medical Group Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Scripps Health Past Accepting new patients

Locations

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

2205 Vista Way
Ste 340
Oceanside, CA 92054
Phone (760) 704-5870

2205 Vista Way
Oceanside, CA 92054
Phone (760) 704-5400

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

Organizations & group practices 8

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.

Hospital & facility affiliations 3

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": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1669620746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10825 ADMIRALS WAY",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208541232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 W NINTH ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014546",
            "telephone_number": "301-695-6800",
            "fax_number": "301-695-6891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2205 Vista Way Ste 340",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "CA",
            "postal_code": "920545661",
            "country_code": "US",
            "telephone_number": "760-704-5870",
            "fax_number": "858-404-1821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LISS",
        "first_name": "GORDON",
        "middle_name": "DANIEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-03",
        "last_updated": "2021-04-06",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "C168998",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MD",
            "license": "MD0070283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.