Alex Benjamin Gordon, DO

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

OT023680 Issued in PA

Practice address

100 E Lancaster Ave
Wynnewood, PA 19096-3450

Phone

(866) 225-5654

NPI assigned

May 28, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1716854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1801636972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "866-225-5654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "866-225-5654"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 S Bryn Mawr Ave",
            "address_purpose": "LOCATION",
            "city": "Bryn Mawr",
            "state": "PA",
            "postal_code": "190103143",
            "country_code": "US",
            "telephone_number": "866-225-5654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "ALEX",
        "middle_name": "BENJAMIN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-28",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "OT023680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Michael Gollomp, MD
• Michael Golub, M.D.
• Eric Gomez, M.D.
• Boas Gonen, M.D.
• Jerry M Gonzales, M.D.
• Gary Gordon, M.D.
• Molly Kaplan Gordon, MD
• Grace Cares Initiative Inc
• Olivia Granja, MD, MS
• William Anthony Gray, M.D.

• Urology Physician in Wynnewood, PA
• Providers in Wynnewood, PA by specialty
• Urology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; 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.