Individual provider Active NPI

Akil Jahi Gordon, MD

  • Surgery Physician
  • Atlanta, GA
National Provider Identifier
1790076180
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
67022 Issued in GA
Practice address
980 Johnson Fy Rd NE Ste 880
Atlanta, GA 30342-1609
Phone
(404) 255-8304
Fax
(404) 256-4578
NPI assigned
Apr 20, 2011
Last updated
Oct 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 67022 GA Primary

Addresses

Primary practice location

980 Johnson Fy Rd NE Ste 880
Atlanta, GA 30342-1609

Mailing address

805 Sandy Plains Road
Medical Staff Services
Marietta, GA 30066-6340

Other practice location 1

55 Whitcher St NE Ste 130
Marietta, GA 30060
Phone (770) 428-0462

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address agordon138298@directwellstar.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20121003000464 GA Practitioner - General Surgery 8921257114 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Jefferson Medical College of Thomas Jefferson University, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Practice addresses (Care Compare)

980 Johnson Fy Rd NE
Suite 880
Atlanta, GA 30342-1609
Phone (404) 255-8304

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Surgical Professional Services LLC Surgery CurrentSince Jan 15, 2024 Accepting new patients
Atlanta Surgery Associates LLC Surgery CurrentSince Jan 3, 2015 Accepting new patients

Locations

550 Peachtree St NE
Ste 1265
Atlanta, GA 30308
Phone (404) 221-1095

550 Peachtree St NE
Ste 1430
Atlanta, GA 30308
Phone (404) 221-1095

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

980 Johnson Fy Rd NE
Ste 880
Sandy Springs, GA 30342
Phone (404) 255-8304

1014 Hospital Dr
Stockbridge, GA 30281
Phone (404) 221-1095

Interoperability endpoints

  • Direct secure messaging: agordon138298@directwellstar.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1303257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1790076180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 SANDY PLAINS ROAD",
            "address_2": "MEDICAL STAFF SERVICES",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300666340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 JOHNSON FY RD NE STE 880",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421609",
            "telephone_number": "404-255-8304",
            "fax_number": "404-256-4578"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Whitcher St NE Ste 130",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "30060",
            "country_code": "US",
            "telephone_number": "770-428-0462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "AKIL",
        "middle_name": "JAHI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-20",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "67022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "agordon138298@directwellstar.org",
            "affiliation": "N",
            "address_1": "55 Whitcher St NE Ste 130",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300601156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.