Gordon Medical Associates PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD044243E Issued in PA

Legal business name

GORDON MEDICAL ASSOCIATES PC

Practice address

6329 N Broad St
Philadelphia, PA 19141-2009

Phone

(215) 924-2244

Fax

(215) 924-2228

NPI assigned

May 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Gordon K Ijelu, M.DNPI 1841244027

Title

Medical Director

Phone

(215) 924-2244

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gordon Ijelu, M.D.

  • Nephrology Physician
  • Philadelphia, PA
  • NPI 1841244027
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356048000000",
    "number": "1962456103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 MUIRFIELD DR",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194221295",
            "telephone_number": "215-924-2244",
            "fax_number": "215-924-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6329 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191412009",
            "telephone_number": "215-924-2244",
            "fax_number": "215-924-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDON MEDICAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2012-12-21",
        "status": "A",
        "authorized_official_last_name": "IJELU",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "215-924-2244",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD044243E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1243184",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Myra Goraya
• Michelle Sabrina Gorbonosov, MD
• Manon Jae Gordan, LPC
• Stephen J Gordin, MD
• Gordon Francis Schwartz MD PC
• Faith Donna Gordon-Mazur, LPC
• Angella Gordon-White
• Alex Jacob Gordon
• Angela Gordon
• Austin Blake Gordon, DO

• Internal Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.