Active NPI
Robert Alan Gordon, M.D.
- Obstetrics & Gynecology Physician
- Sacramento, CA
National Provider Identifier
1871523878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- A86174
- Practice address
- 2425 Alhambra Blvd
Sacramento, CA 95817-1110 - Phone
- (916) 737-5555
- NPI assigned
- Jul 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | A86174 | CA | Primary |
Addresses
Primary practice location
2425 Alhambra Blvd
Sacramento, CA 95817-1110
Mailing address
2334 Keystone Dr
El Dorado Hills, CA 95762-9543
Phone (505) 974-1960
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 95822739 | Medicaid | NM |
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 |
|---|---|---|---|
| A86174 | CA | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatrix Medical Group of California, a Professional Corporation | Past | Accepting new patients |
Organizations & group practices 1
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597795200000",
"number": "1871523878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2334 KEYSTONE DR",
"city": "EL DORADO HILLS",
"state": "CA",
"postal_code": "957629543",
"telephone_number": "505-974-1960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2425 ALHAMBRA BLVD",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958171110",
"telephone_number": "916-737-5555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "ROBERT",
"middle_name": "ALAN",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-04",
"last_updated": "2020-08-19",
"certification_date": "2020-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "CA",
"license": "A86174",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "95822739",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.