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

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: August 23, 2026.

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 Northern Nevada 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
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

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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.

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

Hospital Affiliations CMS Care Compare 4

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

Northern Nevada Medical Center

Acute Care Hospitals · Sparks, NV
3/5 CMS rating
OwnershipProprietary
CMS Certification Number290032
Location2375 E Prater WaySparks, NV 89434 · Washoe County
Emergency services

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.

Internal Medicine (Gastroenterology)
300 PASTEUR DR, ALWAY BUILD M211, MC 5187
STANFORD, CA 94305
Radiology (Vascular & Interventional Radiology)
300 PASTEUR DR
STANFORD, CA 94305
Psychiatry & Neurology (Psychiatry)
300 PASTEUR DR
STANFORD, CA 94305
Radiology (Diagnostic Radiology)
300 PASTEUR DR
STANFORD, CA 94305
Nurse Practitioner
300 PASTEUR DR
STANFORD, CA 94305
Neurological Surgery
300 PASTEUR DR
STANFORD, CA 94305
Pathology (Anatomic Pathology & Clinical Pathology)
300 PASTEUR DR, LANE 235
STANFORD, CA 94305
Internal Medicine (Critical Care Medicine)
300 PASTEUR DR
STANFORD, CA 94305

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.

Is Jacob Gordner affiliated with any hospitals?

According to CMS data, Jacob Gordner is affiliated with Northern Nevada Medical Center, 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.