| Robert T Gordon, MD | |
|
4150 5th St, Rapid City, SD 57701-6022 | |
| (605) 399-4300 | |
| (605) 399-4352 |
| Full Name | Robert T Gordon |
|---|---|
| Gender | Male |
| Speciality | Thoracic Surgery (cardiothoracic Vascular Surgery) |
| Location | 4150 5th St, Rapid City, South Dakota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588604581 | NPI | - | NPPES |
| 060031670 | Other | SD | RAILROAD MEDICARE |
| 4995658 | Other | SD | BLUE CROSS OF SD |
| 7301930 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208G00000X | Thoracic Surgery (cardiothoracic Vascular Surgery) | 5310 (South Dakota) | Primary |
| Entity Name | Permanente Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
| Mailing Address | Practice Location Address |
|---|---|
| Robert T Gordon, MD 4150 5th St, Rapid City, SD 57701-6022 Ph: (605) 399-4300 | Robert T Gordon, MD 4150 5th St, Rapid City, SD 57701-6022 Ph: (605) 399-4300 |
Paul M Orecchia, MD Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Not Enrolled in Medicare Practice Location: 4150 Fifth Street, Rapid City, SD 57701 Phone: 605-399-4300 Fax: 605-399-4352 | |
Tommaso Cambiaghi, Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Accepting Medicare Assignments Practice Location: 353 Fairmont Blvd, Rapid City, SD 57701 Phone: 281-236-4711 | |
Dr. Charan Mungara, MD Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Accepting Medicare Assignments Practice Location: 353 Fairmont Blvd, Monument Health Rapid City Hospital, Rapid City, SD 57701 Phone: 205-441-9459 Fax: 605-755-0707 |