Individual provider Active NPI

Charles S Gordon, M.D.

  • Vascular & Interventional Radiology Physician
  • Venice, FL
National Provider Identifier
1679516124
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
ME0068812 Issued in FL
Practice address
512 Nokomis Ave S
Venice, FL 34285-2817
Phone
(941) 488-7781
Fax
(941) 484-9235
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X ME0068812 FL Primary
Diagnostic Radiology Physician 2085R0202X ME0068812 FL

Addresses

Primary practice location

512 Nokomis Ave S
Venice, FL 34285-2817

Mailing address

PO Box 1508
Venice, FL 34284-1508
Phone (941) 488-7781

Other practice location 1

4724 N Davis Hwy Ste 100
Pensacola, FL 32503-2339
Phone (850) 201-2421

Other practice location 2

161 E Nine Mile Rd Ste 100
Pensacola, FL 32534-3140
Phone (850) 201-2422

Other identifiers 1

IdentifierTypeStateIssuer
265320600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100708000253 FL Practitioner - Diagnostic RadiologyPractitioner - Nuclear MedicinePractitioner - Interventional Radiology 8729119755 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology, Nuclear Medicine
Education
University of Louisville School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SMH Physician Services IncGroup PAC ID 1355240177, 781 clinicians
Mori Bean and Brooks IncGroup PAC ID 8820077878, 966 clinicians
Tower Imaging LLCGroup PAC ID 2860470077, 95 clinicians

Practice addresses (Care Compare)

1700 S Tamiami TRL
Sarasota, FL 34239-3509
Phone (941) 917-7760

2 Tampa General Cir
Tampa, FL 33606-3571
Phone 81325327211937

2001 Kingsley Ave
Orange Park, FL 32073-5148
Phone (904) 399-5550

2115 Little Rd
Trinity, FL 34655-4410
Phone (904) 399-5550

2600 Laurel Rd E
Nokomis, FL 34275-3226
Phone (904) 399-5550

3900 Losillias Dr
Sarasota, FL 34238-4536
Phone (904) 399-5550

5731 Bee Ridge Rd
Sarasota, FL 34233-5056
Phone (904) 399-5550

6500 38TH Ave N
St Petersburg, FL 33710-1629
Phone (904) 399-5550

700 Medical Blvd
Englewood, FL 34223-3964
Phone (904) 399-5550

Hospital & facility affiliations

  • HCA Florida Englewood Hospital Hospital, Englewood, FL, CCN 100267
  • HCA Florida Fawcett Hospital Hospital, Port Charlotte, FL, CCN 100236
  • Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025
  • Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087
  • Sarasota Memorial Hospital - Venice Hospital, North Venice, FL, CCN 100359

Merit-based Incentive Payment System (MIPS)

Final score
78.06 of 100Reported as group
Quality
72.79
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0068812FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Physician Solutions of West Florida, LLC Diagnostic Radiology CurrentSince Sep 15, 2022 Accepting new patients
Florida Diagnostic Imaging Center Inc Diagnostic Radiology CurrentSince Jan 1, 2023 Accepting new patients
Sheridan Radiology Services of Pinellas, Inc. Diagnostic Radiology Current Accepting new patients
Tower Imaging LLC Diagnostic Radiology Current Accepting new patients
Radiology Physician Solutions of West Florida, LLC Diagnostic Radiology CurrentSince Sep 15, 2022 Accepting new patients
Tower Imaging LLC Diagnostic Radiology CurrentSince Mar 22, 2025 Accepting new patients
Florida Diagnostic Imaging Center Inc Diagnostic Radiology CurrentSince Jan 1, 2023 Accepting new patients
SMH Physician Services Inc CurrentSince Feb 2, 2026 Accepting new patients
Mori Bean and Brooks Inc Diagnostic Radiology CurrentSince Nov 23, 2022 Accepting new patients
Pasadena Radiology Associates PA Diagnostic Radiology Past Accepting new patients

Locations

119 Oakfield Dr
Brandon, FL 33511
Phone (813) 571-5150

502 W Highland Blvd
Inverness, FL 34452
Phone (352) 344-6481

700 W Oak St
Kissimmee, FL 34741
Phone (407) 518-3553

2600 Laurel Rd E
North Venice, FL 34275
Phone (941) 261-9000

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

4724 N Davis Hwy
Ste 100
Pensacola, FL 32503
Phone (850) 201-2421

4724 N Davis Hwy
Pensacola, FL 32503
Phone (850) 444-4716

1921 Waldemere St
Ste 307
Sarasota, FL 34239
Phone (941) 917-8565

1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507

13695 US Highway 1
Sebastian, FL 32958
Phone (772) 589-3185

3600 S Highlands Ave
Sebring, FL 33870
Phone (863) 385-6101

1501 Pasadena Ave S
South Pasadena, FL 33707
Phone (727) 341-7777

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

4719 N Habana Ave
Tampa, FL 33614
Phone (813) 874-9769

2 Tampa General Cir
Tampa, FL 33606
Phone (813) 259-8700

2106 S Lois Ave
Tampa, FL 33629
Phone (813) 287-1191

9330 State Road 54
Trinity, FL 34655
Phone (727) 834-4000

2115 Little Rd
Trinity, FL 34655
Phone 7278418225410

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 11

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 5

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1679516124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1508",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342841508",
            "telephone_number": "941-488-7781",
            "fax_number": "941-484-9235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 NOKOMIS AVE S",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342852817",
            "telephone_number": "941-488-7781",
            "fax_number": "941-484-9235"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4724 N Davis Hwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325032339",
            "country_code": "US",
            "telephone_number": "850-201-2421",
            "fax_number": "850-886-2235",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "161 E Nine Mile Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325343140",
            "country_code": "US",
            "telephone_number": "850-201-2422",
            "fax_number": "850-886-2229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "CHARLES",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "FL",
            "license": "ME0068812",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME0068812",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265320600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

Verify at the official NPI Registry.