Individual provider Active NPI

Ginel Chontaie Gordon, NP

  • Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1891288551
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
343029 Issued in NY
Practice address
1555 Long Pond Rd
Rochester, NY 14626-4122
Phone
(585) 723-7870
Fax
(585) 723-7871
NPI assigned
Jun 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 343029 NY Primary

Addresses

Primary practice location

1555 Long Pond Rd
Rochester, NY 14626-4122

Mailing address

111 Lafayette Rd Apt 207
Syracuse, NY 13205-2901
Phone (516) 424-8646

Other practice location 1

601 Elmwood Ave
Rochester, NY 14642-0002
Phone (585) 275-4551

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180924000612 NY Practitioner - Nurse Practitioner 2668723198 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Patient First Medical Practice PCGroup PAC ID 0042687006, 33 clinicians
Medical Director Services PCGroup PAC ID 0042501116, 79 clinicians

Practice addresses (Care Compare)

1256 E 31St St
Brooklyn, NY 11210-4741
Phone (718) 534-0689

19544 Woodhull Ave
Hollis, NY 11423-2982
Phone (718) 740-3500

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester CurrentSince Aug 5, 2018 Accepting new patients
University of Rochester Current Accepting new patients
University of Rochester CurrentSince Aug 5, 2018 Accepting new patients
The Unity Hospital of Rochester Current Accepting new patients
JDS Medical Services PC CurrentSince Dec 9, 2025 Accepting new patients
Medical Director Services PC CurrentSince Feb 18, 2020 Accepting new patients
The Unity Hospital of Rochester CurrentSince Jan 1, 2020 Accepting new patients
Patient First Medical Practice PC CurrentSince Jul 26, 2023 Accepting new patients

Locations

50 Sheffield Ave
Brooklyn, NY 11207
Phone (718) 250-8789

1311 Virginia St
Far Rockaway, NY 11691
Phone (718) 327-2908

19544 Woodhull Ave
Jamaica, NY 11423
Phone (718) 336-2345

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1891288551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 LAFAYETTE RD APT 207",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132052901",
            "telephone_number": "516-424-8646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 LONG POND RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264122",
            "telephone_number": "585-723-7870",
            "fax_number": "585-723-7871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Elmwood Ave",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146420002",
            "country_code": "US",
            "telephone_number": "585-275-4551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "GINEL",
        "middle_name": "CHONTAIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-07",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "343029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.