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TOYA S GORDON MD
NPI 1538401260
Obstetrics & Gynecology - Urogynecology and Reconstructive Pelvic Surgery in Collegeville, PA

Active since March 20, 2013PECOS EnrolledAccepts Medicare Assignment
81.19/100
CMS Quality Rating
300 SPRINGHOUSE DR STE 100, COLLEGEVILLE, PA 19426(484) 323-1400(844) 749-3321 Get Directions Write a Review

NPPES record last updated: March 18, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 18, 2026, Jan 10, 2021, Jul 6, 2020 and 1 more (4 updates tracked since 2018).

About Toya S Gordon Md NPPES

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

TOYA S GORDON MD (NPI 1538401260) is an individual urogynecology and reconstructive pelvic surgery provider in Collegeville, Pennsylvania, licensed in Pennsylvania (MD471126) and active in the NPI registry since March 2013. She is enrolled in Medicare PECOS, is affiliated with Reading Hospital, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1538401260
Entity TypeIndividualFemale
Primary Taxonomy207VF0040X
Provider Legal NameTOYA S GORDONCredential: MD
Location Address300 SPRINGHOUSE DR STE 100Collegeville, PA 19426-4021
Mailing AddressPo Box 42955Belfast, ME 04915-1281 · (484) 323-1400 · Fax (844) 749-3321
Phone(484) 323-1400
Fax(844) 749-3321
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateMarch 20, 2013
Last NPPES UpdateMarch 18, 20264 updates tracked since enumeration
NPPES CertifiedMarch 18, 2026
✔ NPI 1538401260 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyObstetrics & Gynecology · Urogynecology and Reconstructive Pelvic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207VF0040X
License✔ Licensed in PA · MD471126
Definition
A subspecialist in Urogynecology and Reconstructive Pelvic Surgery is a physician in Urology or Obstetrics and Gynecology who, by virtue of education and training, is prepared to provide consultation and comprehensive management of women with complex benign pelvic conditions, lower urinary tract disorders, and pelvic floor dysfunction. Comprehensive management includes those diagnostic and therapeutic procedures necessary for the total care of the patient with these conditions and complications resulting from them.
Also ListedObstetrics & GynecologyTaxonomy 207V00000X · License MD471126 (PA)
300 SPRINGHOUSE DR STE 100, Collegeville, PA 19426
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.Insurance ›

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

Toya S Gordon 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 ID2163720772
PECOS Enrollment IDI20200916001103
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

3

Medicare enrollment records show Toya Gordon reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Journey Well MD PLLC
Same address
Urogynecology and Reconstructive Pelvic Surgery
300 SPRINGHOUSE DR STE 100
Collegeville, PA 19426
  • Reassigned Medicare billing, Pennsylvania enrollment
NPI 1982558466 (484) 323-1400
Phoenixville Clinic Company LLC
3.3 mi
Neurology
140 NUTT RD
Phoenixville, PA 19460
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 529 clinicians in this Medicare group
NPI 1275173957 (610) 983-1100
Tower Health Medical Group
15 mi
Transplant Surgery
8835 GERMANTOWN AVE
Philadelphia, PA 19118
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 1,473 clinicians in this Medicare group
NPI 1306476924 (484) 628-7700

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 10

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.

Injection, onabotulinumtoxina, 1 unit J0585
Onabotulinumtoxina, also known as Botox, is a medication injected into muscles. It's used to treat various conditions by blocking nerve activity in the muscles, causing a temporary reduction in muscle activity. The units refer to the dosage.
1,600 services14 patients
Ultrasound measurement of bladder capacity after voiding 51798
Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.
106 services98 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
73 services55 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
71 services67 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
59 services49 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
32 services32 patients

Hospital Affiliations CMS Care Compare 3

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

Reading Hospital

Acute Care Hospitals · West Reading, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390044
Location420 S 5th AvenueWest Reading, PA 19611 · Berks County
Emergency services Birthing friendly

Pottstown Hospital

Acute Care Hospitals · Pottstown, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390123
Location1600 East High StreetPottstown, PA 19464 · Montgomery County
Emergency services

Paoli Hospital

Acute Care Hospitals · Paoli, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390153
Location255 West Lancaster AvenuePaoli, PA 19301 · Chester County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19426 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$137.17 typical visit price
range $59.88 – $180.99
Typical copayment $34.29 (range $14.97 – $45.24)
Most-billed visit code 99204
Established Patient
$74.47 typical visit price
range $19.30 – $147.29
Typical copayment $18.61 (range $4.82 – $36.82)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

81.19/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality74.56
Promoting Interoperability97
Improvement Activities40
Cost65.23

Other Providers at the Same Location NPPES

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

JOURNEY WELL MD PLLC
Obstetrics & Gynecology (Urogynecology and Reconstructive Pelvic Surgery)
300 SPRINGHOUSE DR STE 100
COLLEGEVILLE, PA 19426
Montgomery County (484) 323-1400

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 Toya Gordon's NPI number?

The NPI number for Toya Gordon is 1538401260. It was assigned to this individual provider in the NPPES registry on March 20, 2013.

Where is Toya Gordon located?

Toya Gordon practices at 300 Springhouse Dr Ste 100, Collegeville, PA 19426. The listed phone number is (484) 323-1400.

What is Toya Gordon's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Urogynecology and Reconstructive Pelvic Surgery, with taxonomy code 207VF0040X.

Is Toya Gordon enrolled in Medicare?

Yes. Toya Gordon 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 Toya Gordon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Toya Gordon reassigns Medicare benefits to 3 organizations: Journey Well MD PLLC (Collegeville, PA), Phoenixville Clinic Company LLC (Phoenixville, PA) and Tower Health Medical Group (Philadelphia, PA). 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 Toya Gordon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Toya Gordon accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Toya Gordon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Toya Gordon affiliated with any hospitals?

According to CMS data, Toya Gordon is affiliated with Reading Hospital, Pottstown Hospital and Paoli Hospital.

When was this NPI record last updated?

The NPPES record for Toya Gordon was last updated on March 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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.