Active NPI
Susanna Reba Gordon, M.D.
- Radiation Oncology Physician
- Riverside, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- License
- G84560
- Practice address
- 6939 Palm CT
Riverside, CA 92506-2815 - Phone
- (951) 683-6771
- NPI assigned
- Jul 12, 2005
- Last updated
- Dec 15, 2020
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | G84560 | CA | Primary |
| Radiation Oncology Physician | 2085R0001X | 49114 | CO | |
| Radiation Oncology Physician | 2085R0001X | 34232 | IA |
Addresses
Primary practice location
6939 Palm CT
Riverside, CA 92506-2815
Mailing address
PO Box 512185
Los Angeles, CA 90051-0185
Phone (626) 775-3514
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CA153446 | Other | CA | MEDICARE PTAN |
| CB216780 | Other | CA | MEDICARE PTAN |
| CA142866 | Other | CA | MEDICARE PTAN |
| 1246710 | Medicaid | IA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | direct@cityofhope.direct-ci.com | CITY OF HOPE MEDICAL FOUNDATION |
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: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Radiation Oncology
- Education
- University of California, Geffen School of Medicine, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1100 San Bernardino Rd
Suite 1100
Upland, CA 91786-4923
Phone (909) 949-2242
6939 Palm CT
Riverside, CA 92506-2815
Phone (951) 683-6771
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.8 of 100
- Quality
- 78.51
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.37
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 49114 | CO | MD | Radiation Oncology Physician |
| 34232 | IA | MD | Radiation Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| City of Hope Medical Foundation | Radiation Oncology | Current | Accepting new patients |
| Empire Oncology PC | Radiation Oncology | Past | Accepting new patients |
| Radiation Oncology Services of Dubuque PC | Radiation Oncology | Past | Accepting new patients |
| J Robert West, M.D., Inc | Past | Accepting new patients |
Locations
1500 Duarte Rd
Duarte, CA 91010
Phone (626) 359-8111
6939 Palm Ct
Riverside, CA 92506
Phone (760) 416-4832
209 Fair Oaks Ave
South Pasadena, CA 91030
Phone (626) 359-8111
36450 Inland Valley Dr
Ste 101
Wildomar, CA 92595
Phone (909) 696-0679
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- direct@cityofhope.direct-ci.com
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba City of Hope Duarte
- Hematology & Oncology Physician
- Duarte, CA
- NPI 1871886366
Radiation Oncology
-
- Radiation Oncology Physician
- Temecula, CA
- NPI 1467764092
-
dba Southern California Dermatology
- Dermatology Physician
- Newport Beach, CA
- NPI 1932154788
-
- Radiation Oncology Physician
- Dubuque, IA
- NPI 1669424958
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Duarte, CA
- NPI 1750358297
-
- General Acute Care Hospital
- Upland, CA
- NPI 1780681189
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607990400000",
"number": "1952309056",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 512185",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900510185",
"telephone_number": "626-775-3514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6939 PALM CT",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925062815",
"telephone_number": "951-683-6771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "SUSANNA",
"middle_name": "REBA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-12",
"last_updated": "2020-12-15",
"certification_date": "2020-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "CA",
"license": "G84560",
"primary": true
},
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "CO",
"license": "49114",
"primary": false
},
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "IA",
"license": "34232",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "CA153446",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "CB216780",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "CA142866",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1246710",
"state": "IA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "direct@cityofhope.direct-ci.com",
"affiliation": "Y",
"affiliationName": "CITY OF HOPE MEDICAL FOUNDATION",
"address_1": "1500 Duarte Rd",
"city": "Duarte",
"state": "CA",
"country_code": "US",
"postal_code": "910103012",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; 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.