Bruce Lewis Gordon, M.D.
Individual provider Active NPI Ophthalmology Physician · Armonk, NY
NPI 1760424758 · NPPES record last updated Feb 1, 2022
Key facts
- NPI
- 1760424758
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Ophthalmology Physician 207W00000X
- License
- 111088 (NY)
- Practice address
- 1 Byram Brook PL
Armonk, NY 10504-2316 - Phone
- (914) 820-0000
- NPI assigned
- Jun 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Owned or controlled facilities with NPI records 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| United Hebrew Geriatric Center |
Skilled nursing facility | Corporate Officer | Jan 1, 2017 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060728000310 | NY | Practitioner - Ophthalmology | 9234142787 |
Reassigns benefits to 2 organizations Practice locations: Harrison, NY |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 111088 | NY | MD | Ophthalmology Physician |
Practice roles (4 of 8)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bruce Lewis Gordon MD PC | Ophthalmology | Current |
Accepting new patients |
| Sight Medical Doctors PLLC | Ophthalmology | Current |
Accepting new patients |
| Sight Medical Doctors PLLC | Current |
Accepting new patients | |
| Westchester Eye Associates | Current | Accepting new patients |
Locations
450 Mamaroneck Ave
Ste 402
Harrison, NY 10528
Phone (914) 949-9200
125 Kennedy Dr
Ste 400
Hauppauge, NY 11788
260 E Middle Country Rd
Ste 201
Smithtown, NY 11787
Phone 6312658780150
170 Maple Ave
Ste 402
White Plains, NY 10601
Phone (914) 698-0670
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 111088 | NY | Yes |
Addresses
Primary practice location
1 Byram Brook PL
Armonk, NY 10504-2316
Mailing address
1 Byram Brook PL
Armonk, NY 10504-2316
Phone (914) 820-0000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00198861 | Medicaid | NY |
Other providers in Armonk, NY
- Jessica Taylor Gasch
- Jasmin Gashti
- Brandi D Gestri
- Julia Ginovker
- Jason Gold
- James Russell Gordon
- Peter Grassi
- Monica Gray
- Daniella Greco
- Daria Ann Grillo
All providers in Armonk, NY · Ophthalmology Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.