| Charles S Gordon, MD | |
|
512 Nokomis Ave S, Venice, FL 34285-2817 | |
| (941) 488-7781 | |
| (941) 484-9235 |
| Full Name | Charles S Gordon |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 33 Years |
| Location | 512 Nokomis Ave S, Venice, Florida |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679516124 | NPI | - | NPPES |
| 265320600 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | ME0068812 (Florida) | Secondary |
| 2085R0204X | Radiology - Vascular & Interventional Radiology | ME0068812 (Florida) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Fawcett Memorial Hospital | Port charlotte, FL | Hospital |
| Englewood Community Hospital | Englewood, FL | Hospital |
| Bayfront Health Port Charlotte | Port charlotte, FL | Hospital |
| Blake Medical Center | Bradenton, FL | Hospital |
| Largo Medical Center | Largo, FL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Tampa Bay Radiology Associates Pa | 1456381136 | 129 |
| Radiology Physician Solutions Of West Florida Llc | 3577876218 | 106 |
| Sheridan Radiology Services Of Pinellas Inc | 7517119407 | 98 |
| Mori Bean And Brooks Inc | 8820077878 | 617 |
| Entity Name | Tower Imaging Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467654244 PECOS PAC ID: 2860470077 Enrollment ID: O20040713000446 |
| Entity Name | Mori Bean And Brooks Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093782070 PECOS PAC ID: 8820077878 Enrollment ID: O20040714001317 |
| Entity Name | Tampa Bay Radiology Associates Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518914977 PECOS PAC ID: 1456381136 Enrollment ID: O20050813000096 |
| Entity Name | Sheridan Radiology Services Of Pinellas Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609211432 PECOS PAC ID: 7517119407 Enrollment ID: O20121128000124 |
| Entity Name | F&s Radiology Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518299957 PECOS PAC ID: 0244368868 Enrollment ID: O20140731002204 |
| Entity Name | Radiology Physician Solutions Of West Florida Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104205046 PECOS PAC ID: 3577876218 Enrollment ID: O20150723008463 |
| Mailing Address | Practice Location Address |
|---|---|
| Charles S Gordon, MD Po Box 1508, Venice, FL 34284-1508 Ph: (941) 488-7781 | Charles S Gordon, MD 512 Nokomis Ave S, Venice, FL 34285-2817 Ph: (941) 488-7781 |
Gary D Wright, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 512 Nokomis Ave S, Venice, FL 34285 Phone: 941-488-7781 Fax: 941-484-9235 | |
Sergio L Selva, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 512 Nokomis Ave S, Venice, FL 34285 Phone: 941-488-7781 Fax: 941-484-9235 | |
Dr. Kimberly Ann Ruzek, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 516 Nokomis Ave S, Venice, FL 34285 Phone: 941-488-7781 | |
Dr. Thomas Francis Barrett Sr., M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 1211 Tuscany Blvd, Venice, FL 34292 Phone: 941-492-4140 Fax: 941-493-7189 | |
Dr. Josiah Bancroft, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 512 Nokomis Ave S, Venice, FL 34285 Phone: 941-488-7781 Fax: 941-486-8991 | |
Dr. Laura Wasylenko Bancroft, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 512 Nokomis Ave S, Venice, FL 34285 Phone: 941-488-7781 Fax: 941-486-8991 | |
Dr. Brian Douglas Lawenda, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 8026 S Tamiami Trail, Venice, FL 34293 Phone: 941-220-6460 Fax: 941-220-5284 |