Gary M Gordon, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

SC001507L Issued in PA

Practice address

2285 Cross Rd
Glenside, PA 19038-5023

Phone

(215) 887-5910

Fax

(215) 887-0387

NPI assigned

Aug 2, 2005

Reactivated

Mar 28, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Gordon Podiatry, LLC

  • Podiatrist
  • Glenside, PA
  • NPI 1609311034
  Medicare reassignment NPD
• Foot Specialists of Moorestown, PC

  • Foot & Ankle Surgery Podiatrist
  • Moorestown, NJ
  • NPI 1609883370
  NPD (past)

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1689675449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2285 CROSS RD",
            "city": "GLENSIDE",
            "state": "PA",
            "postal_code": "190385023",
            "telephone_number": "215-887-5910",
            "fax_number": "215-887-0387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2285 CROSS RD",
            "city": "GLENSIDE",
            "state": "PA",
            "postal_code": "190385023",
            "telephone_number": "215-887-5910",
            "fax_number": "215-887-0387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "GARY",
        "middle_name": "M",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2008-03-18",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC001507L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015356250001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7305038",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "30002264",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE/AMERIHEALTH",
            "identifier": "0060610000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Glenside Dental Associates
• Glenside Dental Care
• Jessica Joyce Gola, MA LPC
• Good Knights Sleep Center, LLC
• Gordon Podiatry, LLC
• Nicole Gozdan
• Kelly Graham
• Louis Mark Gunkel, D.M.D.
• Margaret Maureen Haff, L.AC.
• Hand-in-Hand Therapy, LLC

• Foot & Ankle Surgery Podiatrist in Glenside, PA
• Providers in Glenside, PA by specialty
• Foot & Ankle Surgery Podiatrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.