1. Home
  2. Directory
  3. Pennsylvania
  4. Philadelphia
  5. Pediatrics
  6. NPI Profile

STACY GORDON M.D.
NPI 1821106758
Pediatrics - Pediatric Emergency Medicine in Philadelphia, PA

Active since August 29, 2006PECOS Enrolled
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA, PHILADELPHIA, PA 19104(215) 590-1944(215) 590-4454 Get Directions Write a Review

NPPES record last updated: April 3, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Stacy Gordon M.d. NPPES

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

STACY GORDON M.D. (NPI 1821106758) is an individual pediatric emergency medicine provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD071070L) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1821106758
Entity TypeIndividualFemale
Primary Taxonomy2080P0204X
Provider Legal NameSTACY GORDONCredential: M.D.
Location Address3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIAPhiladelphia, PA 19104-4319
Mailing Address100 E Penn Sq, 9th Floor North TowerPhiladelphia, PA 19107-3323 · (267) 425-9234 · Fax (267) 425-9299
Phone(215) 590-1944
Fax(215) 590-4454
Sole ProprietorNo
Enumeration DateAugust 29, 2006
Last NPPES UpdateApril 3, 2014
✔ NPI 1821106758 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric Emergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080P0204X
License✔ Licensed in PA · MD071070L
Definition
A pediatrician who has special qualifications to manage emergencies in infants and children.
Also ListedPediatricsTaxonomy 208000000X · License MD071070L (PA)
3401 CIVIC CENTER BLVD, Philadelphia, PA 19104
Open in Google Maps ↗

Other Names 1

Former Name (1)Anastasia Gordon M.d.

Other Identifiers 3

Medicaid001803790PA
Medicare UPINE18329
Medicare ID-Type Unspecified042172PA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stacy Gordon M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

AARON DORFMAN M.D.
Pediatrics (Pediatric Cardiology)
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA - CARDIOLOGY
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-4040
MS. NICOLE MARIE KOEPKE CRNP
Nurse Practitioner (Pediatrics)
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA - EMERGENCY MED
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1944
DR. CASSANDRA ALYS LIGH MD
Surgery (Plastic and Reconstructive Surgery)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-2208
DR. PREETI SOI
Psychiatry & Neurology (Child & Adolescent Psychiatry)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-7555
ROSALIND USHER M.D.
Pediatrics (Developmental - Behavioral Pediatrics)
3401 CIVIC CENTER BLVD, DIVISION OF DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-6336
DR. MATTHEW DAVID SCHREIER MD
Pediatrics (Pediatric Cardiology)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
DR. TERRENCE CALDWELL JR. PHARMD
Pharmacist (Pediatrics)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
ALYSSA STIEFEL CRNP
Nurse Practitioner (Pediatrics)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000

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 Stacy Gordon's NPI number?

The NPI number for Stacy Gordon is 1821106758. It was assigned to this individual provider in the NPPES registry on August 29, 2006. The provider is also known as Anastasia Gordon M.D..

Where is Stacy Gordon located?

Stacy Gordon practices at 3401 Civic Center Blvd Children's Hospital Of Philadelphia, Philadelphia, PA 19104. The listed phone number is (215) 590-1944.

What is Stacy Gordon's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Emergency Medicine, with taxonomy code 2080P0204X.

Is Stacy Gordon enrolled in Medicare?

Yes. Stacy Gordon is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Stacy Gordon was last updated on April 3, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.