Individual provider Active NPI

Susan Grace Gordon, O.D.

  • Optometrist
  • Milpitas, CA
National Provider Identifier
1891767604
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7200T Issued in CA
Practice address
1301 E Calaveras Blvd
Milpitas, CA 95035-5543
Phone
(408) 263-2040
NPI assigned
Feb 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7200T CA Primary

Addresses

Primary practice location

1301 E Calaveras Blvd
Milpitas, CA 95035-5543

Mailing address

1301 E Calaveras Blvd
Milpitas, CA 95035-5543
Phone (408) 263-2040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120327000681 CA Practitioner - Optometry 9234399692 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Milpitas Optometric GroupGroup PAC ID 6406013143, 6 clinicians

Practice addresses (Care Compare)

1301 E Calaveras Blvd
Milpitas, CA 95035-5543
Phone 408263204015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7200CAMDAddiction (Substance Use Disorder) Counselor
7200TCAMDOptometrist

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.

NPI Registry JSON

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1891767604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 E CALAVERAS BLVD",
            "city": "MILPITAS",
            "state": "CA",
            "postal_code": "950355543",
            "telephone_number": "408-263-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 E CALAVERAS BLVD",
            "city": "MILPITAS",
            "state": "CA",
            "postal_code": "950355543",
            "telephone_number": "408-263-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "SUSAN",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7200T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milpitas, CA

Sources for this page

Verify at the official NPI Registry.