DR. JACOB SAMUEL GORDNER MD
NPI 1124762026
Student in an Organized Health Care Education/Training Program in Stanford, CA

Q: What is Jacob Gordner's NPI number?

The NPI number for Jacob Gordner is 1124762026. It was assigned to this individual provider in the NPPES registry on April 26, 2022.

Q: What is Jacob Gordner's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Jacob Gordner was last updated on April 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 26, 2022PECOS EnrolledAccepts Medicare Assignment

300 PASTEUR DR, STANFORD, CA 94305(650) 725-1812 Get Directions Write a Review

NPPES record last updated: April 26, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Dr. Jacob Samuel Gordner Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACOB SAMUEL GORDNER MD (NPI 1124762026) is an individual student in an organized health care education/training program in Stanford, California, licensed in California (A175900) and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS, is affiliated with Summerlin Hospital Medical Center, and is a graduate of Queen's School Of Medicine (2017).

NPPES Registry Identity

NPI1124762026

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDR. JACOB SAMUEL GORDNERCredential: MD

Location Address300 PASTEUR DRStanford, CA 94305-2296

Mailing Address103-182 Princess StKingston, ON K7L 1B1

Phone(650) 725-1812

Sole ProprietorYes

Medical School CMSQueen's School Of MedicineGraduated 2017

Enumeration DateApril 26, 2022

NPPES CertifiedApril 26, 2022

✔ NPI 1124762026 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

License✔ Licensed in CA · A175900

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

300 PASTEUR DR, Stanford, CA 94305

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jacob Samuel Gordner Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9931558046

PECOS Enrollment IDI20231214003333

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Jacob Gordner reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Universal Radiology Partners Of Nevada LLC

191 mi

Diagnostic Radiology

1041 STEAMBOAT PKWY
Reno, NV 89521

Reassigned Medicare billing, Nevada enrollment
93 clinicians in this Medicare group

NPI 1588467948 (775) 567-6900

Shelin Agrawal And Hyer PLLC

390 mi

Diagnostic Radiology

657 N TOWN CENTER DR
Las Vegas, NV 89144

Reassigned Medicare billing, Pennsylvania enrollment
3 clinicians in this Medicare group

NPI 1861783961 (752) 210-5954

Ellis Bandt Birkin Kollins & Wong PLLC

393 mi

Diagnostic Radiology

7200 CATHEDRAL ROCK DR STE 230
Las Vegas, NV 89128

Reassigned Medicare billing, Pennsylvania enrollment
6 clinicians in this Medicare group

NPI 1578584678 (702) 623-7568

Radiology Specialists Ltd Marasso-Miller

401 mi

Diagnostic Radiology

3186 S MARYLAND PKWY
Las Vegas, NV 89109

Reassigned Medicare billing, Pennsylvania enrollment
2 clinicians in this Medicare group

NPI 1437196979 (702) 961-5000

Medical Imaging Associates Of Idaho Falls, Inc

638 mi

Diagnostic Radiology

777 HOSPITAL WAY
Pocatello, ID 83201

Reassigned Medicare billing, Pennsylvania enrollment
6 clinicians in this Medicare group

NPI 1740225531 (208) 529-6111

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 41

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml Q9967

Low osmolar contrast material with 300-399 mg/ml iodine concentration is a diagnostic tool used in imaging procedures. It helps to enhance the visibility of specific areas in the body, aiding in accurate diagnosis. It's safe and generally well-tolerated by patients.

3,425 services32 patients

Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml A9579

This is an MRI procedure where a gadolinium-based contrast agent is injected into your body. The agent enhances the images, making it easier to detect abnormalities. It's safe and side effects are rare. It's administered per milliliter as needed.

787 services47 patients

Ultrasound scan of head and neck soft tissue 76536

An ultrasound scan of the head and neck soft tissue is a non-invasive procedure that uses sound waves to create images of the soft tissues in these areas. It helps identify any abnormalities or issues, such as tumors, cysts, or infections. It's painless and doesn't involve radiation.

205 services201 patients

Ct scan of abdomen and pelvis with contrast 74177

A CT scan of the abdomen and pelvis with contrast is an imaging procedure. A special dye, called contrast, is used to make certain areas more visible. This can help identify issues such as infections, tumors, or other abnormalities. The procedure is painless and usually takes about 30 minutes.

156 services153 patients

Ct scan of abdomen and pelvis without contrast 74176

A CT scan of the abdomen and pelvis is a non-invasive medical test. It uses special X-ray equipment to create detailed images of your abdominal and pelvic areas. This helps doctors examine organs, tissues, and vessels. No contrast dye is used in this procedure.

129 services128 patients

Ct scan of blood vessels of chest with contrast 71275

A CT scan of the chest with contrast is a non-invasive imaging test. It uses X-rays and a special dye to get detailed images of your blood vessels in the chest. This helps in diagnosing conditions related to heart and lungs.

109 services109 patients

Complete ultrasound scan behind abdominal cavity 76770

A complete ultrasound scan behind the abdominal cavity is a non-invasive imaging procedure. It uses sound waves to create pictures of the structures and organs located at the back of your abdomen. It helps in diagnosing health conditions and monitoring ongoing treatments.

78 services78 patients

Limited ultrasound scan of abdomen 76705

A limited ultrasound scan of the abdomen is a non-invasive imaging test. It uses sound waves to produce images of the abdominal organs such as the liver, gallbladder, spleen, pancreas, and kidneys. This helps to identify any abnormalities or issues.

59 services59 patients

Mri scan of abdomen before and after contrast 74183

An MRI scan of the abdomen before and after contrast provides detailed images of your abdominal organs. Initially, images are taken without a contrast agent. Then, a safe dye is administered, usually via an IV, to highlight certain areas, giving a clearer picture to help diagnose various conditions.

54 services53 patients

Complete ultrasound scan of abdomen 76700

A complete ultrasound scan of the abdomen is a non-invasive imaging procedure. It uses sound waves to produce images of the organs in your abdomen, such as the liver, gallbladder, spleen, pancreas, and kidneys. It helps in diagnosing, monitoring, and planning treatments.

54 services54 patients

Mri scan of pelvis before and after contrast 72197

An MRI scan of the pelvis before and after contrast is a non-invasive imaging technique. It uses magnetic fields and radio waves to capture detailed images of your lower abdomen. Contrast dye, safe for the body, improves image clarity. This helps detect abnormalities more accurately.

52 services52 patients

Complete ultrasound scan behind abdominal cavity 76770

41 services41 patients

3d radiographic procedure with computerized image postprocessing 76377

A 3D radiographic procedure with computerized image postprocessing is a high-tech imaging test. It uses X-rays to create detailed 3D images of the body. The computerized postprocessing further enhances these images for more precise diagnosis and treatment planning.

39 services39 patients

Mri scan of abdomen without contrast 74181

An MRI scan of the abdomen without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to create detailed pictures of your abdominal organs. This procedure doesn't involve radiation or dye injection.

38 services38 patients

Ct scan of abdomen and pelvis before and after contrast 74178

A CT scan of your abdomen and pelvis with and without contrast helps visualize your internal organs better. Contrast is a special dye that improves the clarity of the images. It's taken orally or injected into your veins before the scan. The process is painless and quick.

37 services37 patients

X-ray of chest, 2 views 71046

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

36 services36 patients

Ct scan of abdomen and pelvis without contrast 74176

32 services32 patients

Ct scan of abdomen and pelvis with contrast 74177

32 services32 patients

X-ray of lower and sacral spine, minimum of 4 views 72110

An X-ray of the lower and sacral spine involves capturing images of your lower back and tailbone area. It helps in identifying issues like fractures, arthritis, or other abnormalities. At least four different angles or 'views' are taken to get a comprehensive picture.

27 services27 patients

Complete ultrasound scan of abdomen 76700

27 services27 patients

X-ray of knee, 4 or more views 73564

An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.

26 services22 patients

Mri scan of abdomen without contrast 74181

26 services26 patients

Ultrasound scan of head and neck soft tissue 76536

24 services24 patients

Limited ultrasound scan of joint or other extremity structure except blood vessels 76882

A limited ultrasound scan of a joint or other extremity structure lacking blood vessels is a non-invasive procedure that uses sound waves to create images of the inside of your body. This helps in diagnosing and monitoring conditions related to your joints or other similar structures.

22 services21 patients

Ultrasound scan of organ tissue for measuring elasticity 76981

An ultrasound scan of organ tissue measures elasticity, or flexibility. This non-invasive procedure uses sound waves to create images of the inside of your body. It helps in assessing the health of various organs by detecting changes in their stiffness or softness.

22 services22 patients

Ct scan of chest without contrast 71250

A CT scan of the chest without contrast is a non-invasive imaging procedure. It uses special X-ray equipment to produce detailed images of your chest area, including your lungs and heart. It can help diagnose conditions such as lung diseases or heart disorders. It doesn't involve any dyes or contrast agents.

20 services20 patients

Mri scan of abdomen before and after contrast 74183

20 services19 patients

3d radiographic procedure with computerized image postprocessing 76377

20 services20 patients

Ct scan of abdomen and pelvis before and after contrast 74178

19 services19 patients

Limited ultrasound scan of abdomen 76705

18 services18 patients

X-ray of lower and sacral spine, 2-3 views 72100

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

16 services16 patients

Ct scan of abdomen before and after contrast 74170

A CT scan of the abdomen before and after contrast is a diagnostic procedure. It involves taking detailed images of your abdomen area. Initially, images are taken without a contrast agent. Then, a contrast dye is given to highlight specific areas inside your body, helping to provide clearer images for better diagnosis.

16 services15 patients

X-ray of chest, 1 view 71045

A chest X-ray, 1 view, is a quick, painless test that produces images of the structures within your chest, such as your heart, lungs, and blood vessels. It helps in diagnosing conditions like pneumonia, heart problems, or lung cancer. You'll stand in front of a machine that emits X-rays, which pass through your body to create the image.

14 services13 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

14 services13 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

14 services14 patients

Ultrasound scan of scrotum 76870

An ultrasound scan of the scrotum is a non-invasive imaging test. It uses sound waves to create pictures of the structures within the lower abdominal area. This helps to assess any discomfort or abnormalities you might be experiencing. The procedure is safe and painless.

13 services11 patients

Ultrasound scan of scrotum 76870

13 services13 patients

Ct scan of chest with contrast 71260

A CT scan of the chest with contrast is an imaging procedure. A special dye (contrast) is used to highlight specific areas in your body, providing clearer pictures of your chest. This helps in diagnosing conditions related to your lungs, heart, and other chest structures.

12 services12 patients

X-ray of upper spine, 4-5 views 72050

An X-ray of the upper spine with 4-5 views is a non-invasive imaging test. It uses radiation to capture detailed images of the bones and structures in your neck and upper back. This procedure helps identify issues like fractures, infections, or deformities.

12 services12 patients

Limited ultrasound scan of pelvis 76857

A limited ultrasound scan of the pelvis is a non-invasive imaging test. It uses high-frequency sound waves to create pictures of the lower abdomen area. This helps doctors view and assess the health of certain internal structures. It's painless and usually takes about 30 minutes.

12 services12 patients

Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina 76830

An ultrasound scan of the lower abdominal region is a safe, non-invasive procedure that uses sound waves to create images of internal structures. This helps in checking the health of reproductive organs and detecting any abnormalities. The scan is done via a small probe inserted into the body.

11 services11 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Summerlin Hospital Medical Center

Acute Care Hospitals · Las Vegas, NV

2/5 CMS rating

OwnershipProprietary

CMS Certification Number290041

Location657 Town Center DriveLas Vegas, NV 89144 · Clark County

Emergency services Birthing friendly

Spring Valley Hospital Medical Center

Acute Care Hospitals · Las Vegas, NV

2/5 CMS rating

OwnershipProprietary

CMS Certification Number290046

Location5400 South Rainbow BlvdLas Vegas, NV 89118 · Clark County

Emergency services Birthing friendly

Centennial Hills Hospital Medical Center

Acute Care Hospitals · Las Vegas, NV

1/5 CMS rating

OwnershipProprietary

CMS Certification Number290054

Location6900 N Durango DrLas Vegas, NV 89149 · Clark County

Emergency services Birthing friendly

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PRISTA CHARUWORN MD

Internal Medicine (Gastroenterology)

300 PASTEUR DR, ALWAY BUILD M211, MC 5187
STANFORD, CA 94305

Santa Clara County (650) 723-6661

ANDREW CHARLES PICEL M.D

Radiology (Vascular & Interventional Radiology)

300 PASTEUR DR
STANFORD, CA 94305

Santa Clara County (650) 723-4000

MATTHEW A WRIGHT M.D. PH.D.

Psychiatry & Neurology (Psychiatry)

300 PASTEUR DR
STANFORD, CA 94305

Santa Clara County (650) 723-4000

DR. QUAZI ZUBAIR AL-TARIQ M.D.

Radiology (Diagnostic Radiology)

300 PASTEUR DR
STANFORD, CA 94305

Santa Clara County (650) 723-4000

ANGIE DEE MURKINS NP

Nurse Practitioner

300 PASTEUR DR
STANFORD, CA 94305

Santa Clara County (650) 723-4000

DR. JAMSHID GHAJAR MD PHD

Neurological Surgery

300 PASTEUR DR
STANFORD, CA 94305

Santa Clara County (650) 723-4000

SARA BAKHTARY M.D.

Pathology (Anatomic Pathology & Clinical Pathology)

300 PASTEUR DR, LANE 235
STANFORD, CA 94305

Santa Clara County (650) 723-5252

YU KUANG LAI MD

Internal Medicine (Critical Care Medicine)

300 PASTEUR DR
STANFORD, CA 94305

Santa Clara County (650) 723-4000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacob Gordner's NPI number?

The NPI number for Jacob Gordner is 1124762026. It was assigned to this individual provider in the NPPES registry on April 26, 2022.

Where is Jacob Gordner located?

Jacob Gordner practices at 300 Pasteur Dr, Stanford, CA 94305. The listed phone number is (650) 725-1812.

What is Jacob Gordner's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jacob Gordner enrolled in Medicare?

Yes. Jacob Gordner is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Jacob Gordner's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacob Gordner reassigns Medicare benefits to 5 organizations: Universal Radiology Partners Of Nevada LLC (Reno, NV), Shelin Agrawal And Hyer PLLC (Las Vegas, NV), Ellis Bandt Birkin Kollins & Wong PLLC (Las Vegas, NV), Radiology Specialists Ltd Marasso-Miller (Las Vegas, NV) and Medical Imaging Associates Of Idaho Falls, Inc (Pocatello, ID). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jacob Gordner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Jacob Gordner affiliated with any hospitals?

According to CMS data, Jacob Gordner is affiliated with Summerlin Hospital Medical Center, Spring Valley Hospital Medical Center and Centennial Hills Hospital Medical Center.

When was this NPI record last updated?

The NPPES record for Jacob Gordner was last updated on April 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.