John David Gordon, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

004758 Issued in NY

Practice address

88 E Tioga Ave Ste 102
88 Tioga Avenue, Ste 102
Corning, NY 14830-2858

Phone

(607) 684-6115

Fax

(607) 684-6120

NPI assigned

Mar 22, 2006

Last updated

Mar 16, 2016By the provider in NPPES

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 4

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Smith Allergy and Asthma of Central New York PLLCGroup PAC ID 3476713033, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Arnot Ogden Medical Center Hospital, Elmira, NY, CCN 330090

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: dgordon@smithallergy.medentdirect.com

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.

• Smith Allergy and Asthma of Central New York PLLC

  • Allergy & Immunology Physician
  • Corning, NY
  • NPI 1700165990
  Medicare reassignment Care Compare group
• Guthrie Medical Group PC

  • Clinical Medical Laboratory
  • Sayre, PA
  • NPI 1649225855
  NPD (past)
• Guthrie Medical Group, P.C.

  • General Practice Physician
  • Sayre, PA
  • NPI 1245246644
  NPD (past)

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

• Arnot Ogden Medical Center

  • General Acute Care Hospital
  • Elmira, NY
  • NPI 1083605661
  Care Compare affiliation

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458086400000",
    "number": "1831158351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 E TIOGA AVE STE 102",
            "address_2": "SMITH ALLERGY & ASTHMA OF CNY PLLC",
            "city": "CORNING",
            "state": "NY",
            "postal_code": "148302858",
            "telephone_number": "607-684-6115",
            "fax_number": "607-684-6120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 E TIOGA AVE STE 102",
            "address_2": "88 TIOGA AVENUE, STE 102",
            "city": "CORNING",
            "state": "NY",
            "postal_code": "148302858",
            "telephone_number": "607-684-6115",
            "fax_number": "607-684-6120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2016-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA051642",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "004758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "J400278137",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP",
            "identifier": "CC9269",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "P00177089",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "GU040061",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emanuel Glicos, R.N.
• Natali Gonzalez, LCSW
• Elizabeth Llyn Goode, MSW
• Kyle Goodrich, PHARMD.
• Ruth Nanette Goodwin, MSW
• Melanie Gotcher, MSW
• Alin Gragossian, D.O.
• Elizabeth Ann Green
• Herman Bernard Greulick, OD
• Kathleen Ann Grottenthaler, RN

• Physician Assistant in Corning, NY
• Providers in Corning, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; 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.