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RANDALL JAY GORDON MD NPI 1174512925


NPI Information

NPI: 1174512925
Provider Name: RANDALL JAY GORDON, MD
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
2320 HIGH ST
BLUE ISLAND, IL
ZIP 60406
Phone: (708) 388-5500
Get Directions

Randall Jay Gordon, MD is an obstetrics gynecology in Blue Island, IL. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. Randall Jay Gordon, MD NPI is 1174512925. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2320 HIGH ST
BLUE ISLAND, IL
ZIP 60406-426
Phone: (708) 388-5500
Fax: (708) 388-5672

The NPI 1174512925 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Cervical or vaginal cancer screening; pelvic and clinical breast examination (HCPCS:G0101)
  • Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory (HCPCS:Q0091)
  • Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • Administration of pneumococcal vaccine (HCPCS:G0009)
  • Administration of influenza virus vaccine (HCPCS:G0008)

The enumeration date for this NPI number is 10/14/2005 and was last updated on 1/12/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207V00000XObstetrics & Gynecology036070173ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1770600MEDICARE PINILLINOIS
2160036380MEDICARE PINILLINOIS
3D16431MEDICARE UPINILLINOIS
4160036380OTHERILLINOISRAILROAD MEDICARE
5036070173MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.