Michael Gordon, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

135718 Issued in NY

Practice address

23 Knott Dr
Glen Cove, NY 11542-4116

Phone

(516) 759-1528

Fax

(516) 759-1528

NPI assigned

Dec 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

State University of New York Downstate Medical Center, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Karat Health, Inc.

  • Behavioral Neurology & Neuropsychiatry Physician
  • Long Island City, NY
  • NPI 1093228801
  NPD (past)
• Lifespire, Inc.

  • Voluntary or Charitable Agency
  • Hollis, NY
  • NPI 1164629788
  NPD (past)
• Lifespire, Inc.

  • Clinic/Center
  • New York, NY
  • NPI 1497709166
  NPD (past)
• United Cerebral Palsy Assoc of Nys Inc.

  dba Cerebral Palsy of NYS

  • Clinic/Center
  • Woodside, NY
  • NPI 1255496642
  NPD (past)

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902961410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 KNOTT DR",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115424116",
            "telephone_number": "516-759-1528",
            "fax_number": "516-759-1528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 KNOTT DR",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115424116",
            "telephone_number": "516-759-1528",
            "fax_number": "516-759-1528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "135718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin Jay Golloub, LCSW, BCD
• Alejo Gomez, MD
• Ashley Annabelle Gonsalves, MD
• Melissa Sue Gonzalez-Vazquez, MSW,CASAC
• Mark Goodstein, MD
• Jennifer Lynn Gorgano, MA
• Aileen Robin Gould, LMHC
• William Joseph Goumas, DPT
• Madison R Grande, RDN
• Beverly Granger, D.D.S.

• Psychiatry Physician in Glen Cove, NY
• Providers in Glen Cove, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.