Petra Gordos

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

Practice address

1155 Pleasant Valley Way
West Orange, NJ 07052-1424

Phone

(973) 731-5100

NPI assigned

Aug 12, 2019

Last updated

Aug 12, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1565568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1982250361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 LINDEN AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070141346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 PLEASANT VALLEY WAY",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521424",
            "telephone_number": "973-731-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDOS",
        "first_name": "PETRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-12",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "CLIFTON",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "79 Linden Ave",
            "city": "Clifton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070141346",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "CLIFTON",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "79 Linden Ave",
            "city": "Clifton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070141346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Geraldine Gomez, M.D.
• Abel Ernesto Gonzalez, M.D.
• Leonardo Gonzalez, LSW
• Goodpoint Medicine P. C.
• Miriam Leiba Gordon, OT
• Nicole Anne Gore
• Brandon Evan Gorny, OTR/L
• Dana Tarese Goss, MA BCBA
• Grace Home Care Solutions LLC (A Better Solution in Home Care)
• Anne-Marie Gizelle Gracia, M.D., MPH

• Physical Therapy Assistant in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Physical Therapy Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.