Individual provider Active NPI

Mara Gordon, MD

  • Family Medicine Physician
  • Camden, NJ
National Provider Identifier
1730575630
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA10625600 Issued in NJ
Practice address
1865 Harrison Ave Ste 1300
Camden, NJ 08105
Phone
(856) 963-0126
NPI assigned
Apr 8, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD046249 DC
Family Medicine Physician 207Q00000X 25MA10625600 NJ Primary

Addresses

Primary practice location

1865 Harrison Ave Ste 1300
Camden, NJ 08105

Mailing address

1 Federal St # 200
Camden, NJ 08103-1088
Phone (856) 356-4924

Other practice location 1

123 45th St NE
Washington, DC 20019
Phone (202) 388-7891

Other practice location 2

51 N 39th St
6 Mutch Building
Philadelphia, PA 19104-2640
Phone (202) 431-1325

Other practice location 3

123 45th St NE
Washington, DC 20019
Phone (202) 388-7891

Other practice location 4

4151 Bladensburg Rd
Colmar Manor, MD 20722-1928
Phone (301) 699-7700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20190912002122 NJ Practitioner - Family Practice 6406107259 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cooper Family Medicine PCGroup PAC ID 4284530197, 117 clinicians

Practice addresses (Care Compare)

1865 Harrison Ave
Suite 1300
Camden, NJ 08105-3660
Phone (856) 963-0126

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.52 of 100Reported as apm
Quality
81.58
Promoting interoperability
99.4
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD046249DCMDFamily Medicine Physician
25MA10625600NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Family Medicine, PC Family Medicine CurrentSince Oct 13, 2024 Accepting new patients
The Cooper Health System Past Accepting new patients
Virtua Our Lady of Lourdes Hospital Inc Past Accepting new patients
Cooper Family Medicine Family Medicine Past Accepting new patients

Locations

1 Federal St
Ste SW200
Camden, NJ 08103
Phone (856) 356-4920

1865 Harrison Ave
Ste 1300
Camden, NJ 08105
Phone (856) 963-0126

3156 River Rd
Camden, NJ 08105
Phone (856) 356-4988

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

504 White Horse Pike
Haddon Hgts, NJ 08035
Phone (856) 546-7990

1001 Lincoln Dr W
Ste F
Marlton, NJ 08053
Phone (609) 810-1800

Interoperability endpoints

  • Direct secure messaging: mgordon67720@direct.cooperhealth.edu

Organizations & group practices 4

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 6

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": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1730575630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST # 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "856-356-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1865 HARRISON AVE STE 1300",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "08105",
            "telephone_number": "856-963-0126"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 45th St NE",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "20019",
            "country_code": "US",
            "telephone_number": "202-388-7891",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "51 N 39th St",
            "address_2": "6 Mutch Building",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191042640",
            "country_code": "US",
            "telephone_number": "202-431-1325",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "123 45th St NE",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "20019",
            "country_code": "US",
            "telephone_number": "202-388-7891",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4151 Bladensburg Rd",
            "address_purpose": "LOCATION",
            "city": "Colmar Manor",
            "state": "MD",
            "postal_code": "207221928",
            "country_code": "US",
            "telephone_number": "301-699-7700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "MARA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-08",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DC",
            "license": "MD046249",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA10625600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.