Alan Howard Gordon, EDD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

2572 Issued in MA

Practice address

45 Walpole St
Ste 6
Norwood, MA 02062-3319

Phone

(781) 769-1646

Fax

(781) 769-4696

NPI assigned

Oct 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Agustin M Florian, MD, PC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Norwood, MA
  • NPI 1942395454
  NPD (past)
• Neponset Valley Neuropsychology, LLC

  • Clinical Psychologist
  • Norwood, MA
  • NPI 1356025928
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511913600000",
    "number": "1689760654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 WALPOLE ST",
            "address_2": "STE 6",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020623319",
            "telephone_number": "781-769-1646",
            "fax_number": "781-769-4696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 WALPOLE ST",
            "address_2": "STE 6",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020623319",
            "telephone_number": "781-769-1646",
            "fax_number": "781-769-4696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "ALAN",
        "middle_name": "HOWARD",
        "name_prefix": "Dr.",
        "credential": "EDD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2017-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MA",
            "license": "2572",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "2572",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0520896",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "W02873",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN BEHAVIORAL HEALT",
            "identifier": "109343",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "719788",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cristian Daniel Gonzalez, M.D.
• Good Health Homecare LLC
• Good Path Health Services Inc
• Roger Good
• Taylor Goodhue, DPT
• Elissa Jill Gordon, LCSW
• Gail Ellen Gordon, LCSW
• Samara Gottlieb
• Carol Gould, CCAR RECOVERY COACH
• Carolyn Jan Gould, RN

• Clinical Neuropsychologist in Norwood, MA
• Providers in Norwood, MA by specialty
• Clinical Neuropsychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.