SAMUEL ANTONIO GORDON PH.D.
NPI 1689684888
Psychologist - Clinical in Washington, DC
About Samuel Antonio Gordon Ph.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAMUEL ANTONIO GORDON PH.D. (NPI 1689684888) is an individual clinical provider in Washington, District Of Columbia, licensed in District Of Columbia (PSY 1528) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Medstar Good Samaritan Hospital, and is a graduate of Other (1987).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 9
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
Samuel Antonio Gordon Ph.d. 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.
Medicare Billing Reassignments
2Medicare enrollment records show Samuel Gordon reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Washington, DC 20010
- Reassigned Medicare billing, District of Columbia and Maryland enrollments
- Also billed through NPI 1376887844 (Maryland)
- 3,530 clinicians in this Medicare group
Landover, MD 20785
- Reassigned Medicare billing, District of Columbia enrollment
- 17 clinicians in this Medicare group
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 3
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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Medstar Good Samaritan Hospital
Acute Care Hospitals · Baltimore, MDPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 20010 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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.
WASHINGTON, DC 20010
WASHINGTON, DC 20010
WASHINGTON, DC 20010
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 Samuel Gordon's NPI number?
The NPI number for Samuel Gordon is 1689684888. It was assigned to this individual provider in the NPPES registry on August 9, 2006.
Where is Samuel Gordon located?
Samuel Gordon practices at 102 Irving St NW, Washington, DC 20010. The listed phone number is (202) 877-1000.
What is Samuel Gordon's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.
Is Samuel Gordon enrolled in Medicare?
Yes. Samuel 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 Samuel Gordon's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Gordon reassigns Medicare benefits to 2 organizations: Medstar Medical Group II LLC (Washington, DC) and Interdynamics, Inc. (Landover, MD). 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 Samuel Gordon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Samuel Gordon affiliated with any hospitals?
According to CMS data, Samuel Gordon is affiliated with Medstar Good Samaritan Hospital.
When was this NPI record last updated?
The NPPES record for Samuel Gordon was last updated on December 11, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Samuel Antonio Gordon, PH.D. · NPI 1689684888
Clinical provider in Washington, District of Columbia. Individual provider, active in the CMS NPPES registry since August 9, 2006.
## Identity
- **NPI:** 1689684888 (Entity type: Individual)
- **Enumerated:** August 9, 2006
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **State license:** PSY 1528 (District of Columbia)
- **Sole proprietor:** No
## Practice location
- **Address:** 102 IRVING ST NW, Washington, DC 20010-2921
- **Phone:** (202) 877-1000 · **Fax:** (202) 291-5366
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Medstar Medical Group II LLC (NPI 1023836137, Washington, DC); Interdynamics, Inc. (NPI 1952570343, Landover, MD) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1987
## Record status
- **NPPES last updated:** December 11, 2007
- **Other identifiers:** Other 5681292; Other 103645; Medicare PIN 009059M53 (DC); and 6 more
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Source: [NPI Profile](https://npiprofile.com/npi/1689684888) · Data from the CMS NPPES public registry.