Leanna Lyn Gordon, D.O.

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

License

DOS-1675 Issued in HI

Practice address

915 N King St
Honolulu, HI 96817-4544

Phone

(808) 848-1438

NPI assigned

Jun 11, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL, HI2 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

Preventive Medicine

Education

Michigan State University College of Osteopathic Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kalihi Palama Health CenterGroup PAC ID 4284544842, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: leanna.gordon.1@28780.direct.athenahealth.com

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.

• Kalihi Palama Health Center

  • Federally Qualified Health Center (FQHC)
  • Honolulu, HI
  • NPI 1457304966
  Medicare reassignment Care Compare group NPD
• Howard Brown Health Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1306048632
  Medicare reassignment NPD
• Kalihi Palama Health Center

  • Federally Qualified Health Center (FQHC)
  • Honolulu, HI
  • NPI 1235908831
  NPD
• Howard Brown Health Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1427523125
  NPD
• Howard Brown Health Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1710437991
  NPD
• Howard Brown Health Center

  • Health Educator
  • Chicago, IL
  • NPI 1811824121
  NPD (past)

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

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1689012742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 N SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 N KING ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968174544",
            "telephone_number": "808-848-1438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "LEANNA",
        "middle_name": "LYN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-11",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "HI",
            "license": "DOS-1675",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "HI",
            "license": "DOS-1675",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036162996",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sergei Gordeev, MD
• Gordon C. Ontai, M.D., Inc.
• Carol Anne Gordon, LCSW
• Emily Gordon
• Katherine Gordon
• Mackeala Gordon
• Tayler Aubrey Mitchell Gorgas, MA, BCBA
• Jorge I Gorriti Arbulu, BEHAVIORAL TECHNICIA
• Josette Kapiolani Gose
• Selena G Goss, MA, MD

• Public Health & General Preventive Medicine Physician in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Public Health & General Preventive Medicine Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.