Dr Ely R Gordon, DO, MPH is a medicare enrolled "Internal Medicine" physician in Madill, Oklahoma. He went to University Of North Texas Hsc, College Of Osteopathic Med and graduated in 1994 and has 30 years of diverse experience with area of expertise as Internal Medicine. He is a member of the group practice Texomacare and his current practice location is
500 Brookside Drive, Po Box 847, Madill, Oklahoma. You can reach out to his office (for appointments etc.) via phone at
(580) 795-5506.
Dr Ely R Gordon is licensed to practice in Missouri (license number 2006023036) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1215992029.
Physician's Profile
| Full Name | Dr Ely R Gordon |
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| Gender | Male |
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| Speciality | Internal Medicine |
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| Experience | 30 Years |
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| Location | 500 Brookside Drive, Madill, Oklahoma |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Ely R Gordon attended and graduated from University Of North Texas Hsc, College Of Osteopathic Med in 1994
NPI Data:
- NPI Number: 1215992029
- Provider Enumeration Date: 04/18/2006
- Last Update Date: 03/17/2018
Medicare PECOS Information:
- PECOS PAC ID: 7517869282
- Enrollment ID: I20180123002003
Medical Identifiers
Medical identifiers for Dr Ely R Gordon such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1215992029 | NPI | - | NPPES |
| 0411221 | Other | | UNITED HEALTHCARE |
| 110187817 | Other | | RR MEDICARE |
| 000008373 | Medicaid | AL | |
| 51008373 | Other | | BCBS |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207R00000X | Internal Medicine | DO 621 (Alabama) | Secondary |
| 208000000X | Pediatrics | DO 621 (Alabama) | Secondary |
| 208000000X | Pediatrics | 2006023036 (Missouri) | Secondary |
| 207R00000X | Internal Medicine | 2006023036 (Missouri) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Texomacare | 3678555307 | 48 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Ely R Gordon allows following entities to bill medicare on his behalf.
| Entity Name | Texomacare |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1407800857
PECOS PAC ID: 3678555307
Enrollment ID: O20040624000037 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Ely R Gordon is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Ely R Gordon, DO, MPH
5012 S Us Hwy 75, Suite 300, Attn Billing,
Denison, TX 75020-4589
Ph: (580) 795-5506 | Dr Ely R Gordon, DO, MPH
500 Brookside Drive, Po Box 847,
Madill, OK 73446-0847
Ph: (580) 795-5506 |
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