Individual provider Active NPI

Brian M Gordon, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Schenectady, NY
National Provider Identifier
1982694014
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
209643 Issued in NY
Practice address
530 Liberty St
Schenectady, NY 12305-2014
Phone
(518) 382-7200
Fax
(518) 382-7205
NPI assigned
Oct 28, 2005
Sex
Male
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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 209643 NY
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 209643 NY
Orthopaedic Surgery of the Spine Physician 207XS0117X 209643 NY
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X 209643 NY
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 209643 NY Primary

Addresses

Primary practice location

530 Liberty St
Schenectady, NY 12305-2014

Mailing address

530 Liberty St
Schenectady, NY 12305-2014
Phone (518) 382-7200

Other identifiers 1

IdentifierTypeStateIssuer
01935579MedicaidNY

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20051017000793 NY Practitioner - Orthopedic Surgery 8022034388 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
209643NYMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter'S Hospital of the City of Albany CurrentSince Aug 1, 2010 Accepting new patients
St. Peter'S Hospitalof the City of Albany CurrentSince Aug 1, 2010 Accepting new patients
St. Peter'S Hospital of the City of Albany Current Accepting new patients
Schenectady Regional Orthopedic Associates, PC Orthopaedic Surgery Past Accepting new patients

Locations

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

4 Palisades Dr
Ste 200
Albany, NY 12205
Phone (518) 591-1121

1182 Troy Schenectady Rd
Ste 100
Latham, NY 12110
Phone (518) 269-4690

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1982694014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 LIBERTY ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123052014",
            "telephone_number": "518-382-7200",
            "fax_number": "518-382-7205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 LIBERTY ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123052014",
            "telephone_number": "518-382-7200",
            "fax_number": "518-382-7205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "BRIAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "209643",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "NY",
            "license": "209643",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "NY",
            "license": "209643",
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "NY",
            "license": "209643",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NY",
            "license": "209643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01935579",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Schenectady, NY

Sources for this page

Verify at the official NPI Registry.