Active NPI
Lisa A Gordon, MD
- Family Medicine Physician
- Worcester, MA
National Provider Identifier
1861478984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 160026
- Practice address
- 108 Belmont St
Worcester, MA 01605-4902 - Phone
- (508) 334-1443
- Fax
- (508) 334-1448
- NPI assigned
- Dec 20, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 160026 | MA | Primary |
Addresses
Primary practice location
108 Belmont St
Worcester, MA 01605-4902
Mailing address
PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 160026 | MA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edward M. Kennedy Community Health Center, Inc | Past | Accepting new patients | |
| Edward M. Kennedy Community Health Center, Inc | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Clinic Pharmacy
- Worcester, MA
- NPI 1013048347
-
- Federally Qualified Health Center (FQHC)
- Worcester, MA
- NPI 1316324650
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391126400000",
"number": "1861478984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 415348",
"city": "BOSTON",
"state": "MA",
"postal_code": "022415348",
"telephone_number": "800-225-8885",
"fax_number": "508-334-1977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 BELMONT ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016054902",
"telephone_number": "508-334-1443",
"fax_number": "508-334-1448"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "LISA",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-20",
"last_updated": "2014-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MA",
"license": "160026",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.