Michael A Gordon, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC2941 Issued in FL

Practice address

3901 NW 79TH Ave Ste 105
Doral, FL 33166-6554

Phone

(305) 431-2034

Fax

(305) 717-9995

NPI assigned

Aug 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL, TN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• TN Doctors of Optometry, PLLC

  • Optometrist
  • Collierville, TN
  • NPI 1538827050
  Medicare reassignment NPD
• Comprehensive Eye Care of South Florida Inc

  • Optometrist
  • Miami Lakes, FL
  • NPI 1063670636
  NPD (past) Authorized official
• TN Doctors of Optometry, PLLC

  • Eyewear Supplier
  • Kingsport, TN
  • NPI 1275299562

  Optometrist

  NPD
• Premier Eye Group Inc

  • Optometrist
  • Miami, FL
  • NPI 1730458456
  NPD (past)

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542326400000",
    "number": "1801807912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 NW 79TH AVE STE 105",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666554",
            "telephone_number": "305-431-2034",
            "fax_number": "305-717-1558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 NW 79TH AVE STE 105",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666554",
            "telephone_number": "305-431-2034",
            "fax_number": "305-717-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2018-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6205305",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Symon Gooding
• Blanca Mercedes Gordillo Suarez, SA-C
• Jennifer Gordillo
• Annee Gordon
• Matthieu Gordon, PA-C
• Elisabet Gort
• Carmen Goudet Fabelo, APRN
• Ana Cristina Gouvea, MHC
• Osvaldo Govin Cabodevilla
• Grace & Growth Counseling LLC

• Optometrist in Doral, FL
• Providers in Doral, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.