Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Charles Gordon Jr., PA-C

Individual provider Physician Assistant · NPI 1114382025

Mr. Charles Gordon Jr., PA-C is a Physician Assistant in Albany, New York. Qualified in 2015, 11 years ago. Practices with St Peters Hospital of the City of Albany, a 268-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
11
Licensed in
NY
In the registry since
2015
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

315 S Manning Blvd
Albany, NY 12208-1707
Phone: (518) 252-1550
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 019257 (NY)

Record details

NPI number1114382025
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 18, 2015
Last updated in NPPESMay 20, 2021
Certification dateMay 20, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice St Peters Hospital Of The City Of Albany — 268 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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