DR. GERALD GORDON M.D.
NPI 1396738753
Internal Medicine in Aiken, SC

NPI Status: Active since August 31, 2005

Contact Information

102 SUMMERWOOD WAY
AIKEN, SC
ZIP 29803
Phone: (803) 649-5300
Fax: (803) 649-0056

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Insurance Plans Accepted
Medicare Participation & PECOS Status
Areas of Expertise
Durable Medical Equipment
Physician Visit Costs
Quality Reporting
Hospital Affiliations - Privileges
CLIA Information
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 51
Internal Medicine
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting
CLIA Number: 42D0940854
CLIA Cert. Type: Physician Office
CLIA Exp. Date: 02-17-2026

About GERALD GORDON

This page provides the complete NPI Profile along with additional information for Gerald Gordon, an internist established in Aiken, South Carolina with a medical specialization in Internal Medicine and more than 51 years of experience. He graduated from Columbia University College Of Physicians And Surgeons in 1975. The healthcare provider is registered in the NPI registry with number 1396738753 assigned on August 2005. The practitioner's primary taxonomy code is 207R00000X with license number 17475 (SC). The provider is registered as an individual and his NPI record was last updated 19 years ago.

NPI: 1396738753
Provider Name: DR. GERALD GORDON M.D.
Gender: Male
Entity Type: Individual
Location Address: 102 SUMMERWOOD WAY AIKEN, SC 29803
Location Phone: (803) 649-5300
Location Fax: (803) 649-0056
Mailing Address: PO BOX 5238 AIKEN, SC 29804
Mailing Phone: (803) 649-5300
Mailing Fax: (803) 649-0056
Medical School Name: COLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS
Graduation Year: 1975
Is Sole Proprietor?: No
Enumeration Date: 08-31-2005
Last Update Date: 10-22-2007
Code Navigator

An internist like Gerald Gordon is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Internal Medicine
Taxonomy Code: 207R00000X
Type: Allopathic & Osteopathic Physicians
License No.: 17475
License State: SC
Taxonomy Description: A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No.	Taxonomy Code	Type	Classification / Specialization	License No. (State)
1	207RI0200X	Allopathic & Osteopathic Physicians	Internal Medicine Infectious Disease	17475 (SC)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Ambetter from Absolute Total Care

Elite Bronze - HMO
Elite Bronze + Vision + Adult Dental - HMO
Everyday Bronze - HMO
Everyday Bronze + Vision + Adult Dental - HMO
Focused Silver - HMO
Standard Expanded Bronze - HMO
Standard Gold - HMO
Standard Silver - HMO
Standard Silver + Vision + Adult Dental - HMO

Ambetter of North Carolina

Clear Silver with $0 Insulin Options - HMO
Complete Gold - HMO
Complete Gold + Vision + Adult Dental - HMO
Complete Gold with Atrium Health - HMO
Complete Gold with Atrium Health + Vision + Adult Dental - HMO
Elite Bronze - HMO
Elite Bronze + Vision + Adult Dental - HMO
Elite Bronze with Atrium Health - HMO
Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
Enhanced Asthma/COPD Care Silver with $0 Drug Options - HMO

BlueCross BlueShield of South Carolina

Blue Direction Bronze 1 - POS
Blue Direction Silver 1 - POS
Blue Direction Silver 1 + Adult Vision - POS
Blue Direction Silver 2 - POS
Blue Direction Standard Expanded Bronze - POS
Blue Direction Standard Gold - POS
Blue Direction Standard Silver - POS
Blue VirtuConnect Bronze 1 - EPO
Blue VirtuConnect Gold 1 - EPO
Blue VirtuConnect Silver 1 - EPO

Molina Healthcare

Molina Gold Core 1640 - HMO
Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
Molina Gold Core 1640 Plus with Adult Vision - HMO
Molina Gold Standard - HMO
Molina Gold Value - HMO
Molina Gold Value Plus with Adult Dental and Vision - HMO
Molina Gold Value Plus with Adult Vision - HMO
Molina Silver Core - HMO
Molina Silver Core Plus with Adult Dental and Vision - HMO
Molina Silver Core Plus with Adult Vision - HMO

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State	Identifier Issuer
174750	MEDICAID (05)	SC
C29332	MEDICARE UPIN (02)	SC

Medicare Participation & PECOS Enrollment Status

Gerald Gordon is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Gerald Gordon is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
PECOS PAC ID: 4587650791
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.
PECOS Enrollment ID: I20100628000445
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.
Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

DME-Other DME (DE017N)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)
15 DME suppliers used 67 Medicare Claims 250 Services Paid
DME-Medical/Surgical Supplies (DA000N)
Lancets, per box of 100 (HCPCS:A4259)
7 DME suppliers used 23 Medicare Claims 44 Services Paid
DME-Other DME (DE001N)
Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)
4 DME suppliers used 23 Medicare Claims 23 Services Paid
DME-Other DME (DE001N)
Full face mask used with positive airway pressure device, each (HCPCS:A7030)
4 DME suppliers used 19 Medicare Claims 19 Services Paid
DME-Other DME (DE001N)
Face mask interface, replacement for full face mask, each (HCPCS:A7031)
4 DME suppliers used 13 Medicare Claims 36 Services Paid
DME-Other DME (DE001N)
Pillow for use on nasal cannula type interface, replacement only, pair (HCPCS:A7033)
2 DME suppliers used 12 Medicare Claims 68 Services Paid
DME-Other DME (DE001N)
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap (HCPCS:A7034)
3 DME suppliers used 18 Medicare Claims 18 Services Paid
DME-Other DME (DE001N)
Headgear used with positive airway pressure device (HCPCS:A7035)
3 DME suppliers used 19 Medicare Claims 19 Services Paid
DME-Other DME (DE001N)
Tubing used with positive airway pressure device (HCPCS:A7037)
3 DME suppliers used 13 Medicare Claims 13 Services Paid
DME-Other DME (DE001N)
Filter, disposable, used with positive airway pressure device (HCPCS:A7038)
5 DME suppliers used 32 Medicare Claims 190 Services Paid
DME-Other DME (DE001N)
Water chamber for humidifier, used with positive airway pressure device, replacement, each (HCPCS:A7046)
4 DME suppliers used 17 Medicare Claims 17 Services Paid
DME-Oxygen and Supplies (DC000N)
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)
2 DME suppliers used 31 Medicare Claims 34 Services Paid
DME-Other DME (DE001N)
Continuous positive airway pressure (cpap) device (HCPCS:E0601)
3 DME suppliers used 37 Medicare Claims 37 Services Paid
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
2 DME suppliers used 44 Medicare Claims 47 Services Paid
DME-Other DME (DE017N)
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)
6 DME suppliers used 83 Medicare Claims 84 Services Paid

Unknown

Other-Enteral and Parenteral (OB005N)
Parenteral nutrition solution, not otherwise specified, 10 grams lipids (HCPCS:B4185)
2 DME suppliers used 52 Medicare Claims 1083 Services Paid
Other-Enteral and Parenteral (OB005N)
Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, over 100 grams of protein - premix (HCPCS:B4199)
2 DME suppliers used 45 Medicare Claims 314 Services Paid
Other-Enteral and Parenteral (OB005N)
Parenteral nutrition supply kit; premix, per day (HCPCS:B4220)
2 DME suppliers used 52 Medicare Claims 364 Services Paid
Other-Enteral and Parenteral (OB005N)
Parenteral nutrition administration kit, per day (HCPCS:B4224)
2 DME suppliers used 52 Medicare Claims 364 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Adm sarscov2 100mcg/0.5ml3rd
Adm sarscv2 30mcg trs-sucr b
Administration of influenza virus vaccine
Administration of pneumococcal vaccine
Administration of vaccine
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
Anticoagulant management of patient taking warfarin
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with provider supplied equipment
Coronavirus vaccine 13
Coronavirus vaccine 14
Creatinine level to test for kidney function or muscle injury
Established patient office or other outpatient visit, 10-19 minutes
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes
Fee covid-19 vac 13 res
Fee covid-19 vac 14 res
Follow-up hospital inpatient care per day, typically 25 minutes
Follow-up hospital inpatient care per day, typically 35 minutes
Hemoglobin a1c level
Hospital discharge day management, 30 minutes or less
Influenza vaccine split virus, preservative free
Influenza vaccine, quadrivalent, 0.5 ml dosage
Initial hospital inpatient care per day, typically 70 minutes
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and
Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only
Sarscov2 vac 30 mcg trs-sucr
Sarscov2 vac 50mcg/0.25ml im
Transitional care management services for problem of moderate complexity
Urinalysis, manual test
Urine microalbumin (protein) analysis

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $31.01 for a new patient copayment and $23.78 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 29803 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

Average New Patient Price $124.04
Minimum New Patient Price $53.57
Maximum New Patient Price $163.84

Average New Patient Copayment $31.01
Minimum New Patient Copayment $13.39
Maximum New Patient Copayment $40.96

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

Average Established Patient Price $95.12
Minimum Established Patient Price $16.96
Maximum Established Patient Price $133.52

Average Established Patient Copayment $23.78
Minimum Established Patient Copayment $4.24
Maximum Established Patient Copayment $33.38

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure	Performance	Number of Patients
Annual registration in the Prescription Drug Monitoring Program	Yes	N/A
Annual registration by eligible clinician or group in the prescription drug monitoring program of the state where they practice. Activities that simply involve registration are not sufficient. MIPS eligible clinicians and groups must participate for a minimum of 6 months.
Care transition standard operational improvements	Yes	N/A
Establish standard operations to manage transitions of care that could include one or more of the following: Establish formalized lines of communication with local settings in which empaneled patients receive care to ensure documented flow of information and seamless transitions in care; and/or Partner with community or hospital-based transitional care services.
e-Prescribing	91%	4230
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Health Information Exchange	1%	626
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral.
Immunization Registry Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data.
Medication Reconciliation	84%	241
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Patient-Specific Education	84%	1445
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Provide Patient Access	74%	1445
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Secure Messaging	3%	1445
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk Analysis	Yes	N/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Gerald Gordon is affiliated with the following medical facilities:

Hospital Name	Address	Phone	Hospital Type	Overall Rating
PIEDMONT AUGUSTA HOSPITAL	1350 WALTON WAY AUGUSTA, GA 30901	(706) 722-9011	Acute Care Hospitals
AIKEN REGIONAL MEDICAL CENTER	302 UNIVERSITY PARKWAY AIKEN, SC 29801	(803) 641-5900	Acute Care Hospitals

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number: 42D0940854
Facility Type: Physician Office
Certificate Effective Date: February 18, 2024
Certificate Expiration Date: February 17, 2026
Laboratory Director: GERALD GORDON
Certificate Type: Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description: This CLIA certificate is issued to Gerald Gordon in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1396738753, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 18 → 1 + 8

Pos 4

Unchanged

Pos 5

Doubled → 14 → 1 + 4

Pos 6

Unchanged

Pos 7

Doubled → 16 → 1 + 6

Pos 8

Unchanged

Pos 9

Doubled → 10 → 1 + 0

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 9 → 18 → 9 7 → 14 → 5 8 → 16 → 7 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 1 + 8 + 6 + 1 + 4 + 3 + 1 + 6 + 7 + 1 + 0 + 24 = 67

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 67 is 70. The difference is the calculated check digit.

70 - 67 = 3

This NPI is valid

The calculated check digit is 3, which matches the last digit of 1396738753.