Zachary Nathan Gordon, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

01077056A Issued in IN

Practice address

2705 N Lebanon St Ste 265
Lebanon, IN 46052

Phone

(765) 485-8730

Fax

(765) 485-8739

NPI assigned

Apr 11, 2011

Sex

Male

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

Other names 1

• Zach Gordon Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Urology

Education

Warren Alpert Medical School of Brown University, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Witham Memorial HospitalGroup PAC ID 4082523170, 107 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Witham Health Services Hospital, Lebanon, IN, CCN 150104

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: zgordon@withamdirect.org

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.

• Witham Memorial Hospital

  • Family Medicine Physician
  • Lebanon, IN
  • NPI 1083750293
  Medicare reassignment Care Compare group NPD
• University Urologists, Inc., PC

  • Urology Physician
  • Indianapolis, IN
  • NPI 1104877141
  Medicare reassignment NPD
• Witham Memorial Hospital

  • Physical Therapist
  • Zionsville, IN
  • NPI 1952282204
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Witham Memorial Hospital

  • General Acute Care Hospital
  • Lebanon, IN
  • NPI 1699757401
  Care Compare affiliation

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

{
    "created_epoch": "1302480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1790075851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 N LEBANON ST",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460521476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 N LEBANON ST STE 265",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "46052",
            "telephone_number": "765-485-8730",
            "fax_number": "765-485-8739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "ZACHARY",
        "middle_name": "NATHAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-11",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083C0008X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Clinical Informatics",
            "state": "IN",
            "license": "01077056A",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IN",
            "license": "01077056A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201369920",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "zgordon@withamdirect.org",
            "affiliation": "Y",
            "affiliationName": "Witham Memorial Hospital",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2705 N Lebanon St Ste 265",
            "city": "Lebanon",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ZACH",
            "last_name": "GORDON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Bailey C Goodman, PA-C
• Emily Goodman
• Lyndsey M Goodrich, RBT
• Dorothea Mueller Goold, M.S.,LMFT
• Eitan M Gordon, ED.S.
• Chasity Graham
• Grand Heart, LLC
• Christian P Gray, RBT
• Phillip Wesley Graybiel, LMHC
• Cassandra Green, FNP

• Urology Physician in Lebanon, IN
• Providers in Lebanon, IN by specialty
• Urology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; 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.