MR. ODELL DELROY GORDON NP NPI 1659784809

NPI Information

  • NPI: 1659784809
  • Provider Name: MR. ODELL DELROY GORDON, NP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 40 HURLEY AVE
    SUITE 4
    KINGSTON, NY
    ZIP 12401
  • Phone: (845) 338-5600

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NPI Details

MR. Odell Delroy Gordon, NP is a family nurse practitioner in Kingston, NY with 11 years of experience. MR. Odell Delroy Gordon, NP NPI is 1659784809. 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:

40 HURLEY AVE
SUITE 4
KINGSTON, NY
ZIP 12401-739
Phone: (845) 338-5600
Fax: (845) 338-3058

The NPI 1659784809 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.

  • Emergency department visit for problem of moderate severity (HCPCS:99283)
  • Emergency department visit for problem of high severity (HCPCS:99284)

The enumeration date for this NPI number is 6/5/2014 and was last updated on 5/16/2024.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyF338818-1NEW YORKNo
2363LF0000XNurse PractitionerFamily26NJ14923500NEW JERSEYYes

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: 3/30/2025

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