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MR. ODELL DELROY GORDON NP
NPI 1659784809
Nurse Practitioner - Family in Kingston, NY

Active since June 05, 2014PECOS EnrolledAccepts Medicare Assignment
40 HURLEY AVE, SUITE 4, KINGSTON, NY 12401(845) 338-5600(845) 338-3058 Get Directions Write a Review

NPPES record last updated: May 16, 2024. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: May 16, 2024, Mar 11, 2020 (2 updates tracked since 2020).

About Mr. Odell Delroy Gordon Np NPPES

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

MR. ODELL DELROY GORDON NP (NPI 1659784809) is an individual family provider in Kingston, New York, licensed in New Jersey (26NJ14923500) and active in the NPI registry since June 2014. He is enrolled in Medicare PECOS, is affiliated with Trinitas Regional Medical Center, and maintains a secondary practice location in Elizabeth.

NPPES Registry Identity

NPI1659784809
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameMR. ODELL DELROY GORDONCredential: NP
Location Address40 HURLEY AVE, SUITE 4Kingston, NY 12401-3739
Mailing Address40 Hurley Ave, Suite 4Kingston, NY 12401-3739 · (845) 338-5600 · Fax (845) 338-3058
Phone(845) 338-5600
Fax(845) 338-3058
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateJune 5, 2014
Last NPPES UpdateMay 16, 20242 updates tracked since enumeration
NPPES CertifiedMay 16, 2024
✔ NPI 1659784809 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses✔ Licensed in NJ · 26NJ14923500✔ Licensed in NY · F338818-1
40 HURLEY AVE, Kingston, NY 12401
Open in Google Maps ↗

Secondary Practice Location 1

Location 1225 Williamson StElizabeth, NJ 07202-3625 · Phone (908) 994-5000

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

Mr. Odell Delroy Gordon Np 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 ID1759603020
PECOS Enrollment IDI20240215002075
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

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.

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.
16 services16 patients

Hospital Affiliations CMS Care Compare

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

Trinitas Regional Medical Center

Acute Care Hospitals · Elizabeth, NJ
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310027
Location225 Williamson StreetElizabeth, NJ 07207 · Union County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 12401 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
$95.99 typical visit price
range $61.88 – $187.05
Typical copayment $23.99 (range $15.47 – $46.76)
Most-billed visit code 99203
Established Patient
$108.56 typical visit price
range $19.92 – $151.94
Typical copayment $27.14 (range $4.98 – $37.98)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

DR. BARDEV KAPILA MD
Otolaryngology
40 HURLEY AVE, STE 15
KINGSTON, NY 12401
Ulster County (845) 338-1825
WILLIAM TWEEDDALE P.A.
Physician Assistant
40 HURLEY AVE, SUITE 4
KINGSTON, NY 12401
Ulster County (845) 338-5600
DONNA JEAN HANNIGAN NP
Nurse Practitioner (Family)
40 HURLEY AVE
KINGSTON, NY 12401
Ulster County (845) 338-0180
ANDERSON MEDICAL P.C. DBA EMERGENCY ONE
Clinic/Center (Urgent Care)
40 HURLEY AVE, SUITE 4
KINGSTON, NY 12401
Ulster County (845) 338-5600
DR. SAMUEL PAI DDS
Dentist (Periodontics)
40 HURLEY AVE, SUITE 6
KINGSTON, NY 12401
Ulster County (845) 331-7775
DR. PAUL PAI D.D.S.
Dentist (Endodontics)
40 HURLEY AVE
KINGSTON, NY 12401
Ulster County (845) 331-7775
JILL MARIE TSCHINKEL FNP
Nurse Practitioner
40 HURLEY AVE, SUITE 4
KINGSTON, NY 12401
Ulster County (845) 338-5600
DR. FERDINAND ANDERSON JR. M.D.
Emergency Medicine (Emergency Medical Services)
40 HURLEY AVE, SUITE 4
KINGSTON, NY 12401
Ulster County (845) 338-5600

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 Odell Gordon's NPI number?

The NPI number for Odell Gordon is 1659784809. It was assigned to this individual provider in the NPPES registry on June 5, 2014.

Where is Odell Gordon located?

Odell Gordon practices at 40 Hurley Ave Suite 4, Kingston, NY 12401. The listed phone number is (845) 338-5600.

What is Odell Gordon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Odell Gordon enrolled in Medicare?

Yes. Odell 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.

Is Odell Gordon affiliated with any hospitals?

According to CMS data, Odell Gordon is affiliated with Trinitas Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Odell Gordon was last updated on May 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.