Raquel W Gordon, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY1877 Issued in DC

Practice address

1053 Buchanan St NE
Washington, DC 20017-2712

Phone

(202) 854-4889

NPI assigned

Nov 9, 2017

Last updated

May 28, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, MD2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Psychologist

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Axis Healthcare GroupGroup PAC ID 1254409550, 76 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Axis Healthcare Group

  dba CareMind Health

  • Psychiatry Physician
  • Silver Spring, MD
  • NPI 1326295098

  DC

  Medicare reassignment Care Compare group NPD
• Providence Hospital

  dba Providence Hospital Urgent Care Center

  • General Acute Care Hospital
  • Washington, DC
  • NPI 1932190626
  NPD (past)

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

{
    "created_epoch": "1510185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559001600000",
    "number": "1831602085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16612 PEACH ST",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163526",
            "telephone_number": "301-356-6698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1053 BUCHANAN ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200172712",
            "telephone_number": "202-854-4889"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7 Saint Paul St Ste 820",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212021681",
            "country_code": "US",
            "telephone_number": "800-370-3651",
            "fax_number": "877-515-7147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "RAQUEL",
        "middle_name": "W",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-09",
        "last_updated": "2019-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "03284",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "DC",
            "license": "PSY1877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natisha Gordon
• Neva Gordon
• Olivia French Gordon
• Oren Gordon, MD
• Peter Gordon
• Robert Stevenson Gordon III, DO
• Samuel Antonio Gordon, PH.D.
• Sanlare Gordon, D.O.
• Sara Nicole Powers Gordon, NP
• Shantae Gordon

• Psychologist in Washington, DC
• Providers in Washington, DC by specialty
• Psychologist in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2019; 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.