DR. KENNETH BRYCE GORDON (OD) – Optometrist, NPI 1497752208

DR. KENNETH BRYCE GORDON (OD) is a healthcare provider. based in Richmond, Virginia. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 0618000495 (VA). The NPI Number for DR. KENNETH BRYCE GORDON (OD) is 1497752208

Main info

Male
30 Years Of Experience
Accepts Medicare Assignment
Name
DR. KENNETH BRYCE GORDON (OD)
NPI
1497752208
Phone
(804) 226-1144
Address
4811 S LABURNUM AVE
Enumeration Date
7 July 2005
Last Update Date
21 May 2013

Doctor Profile

Medical School Name
PENNSYLVANIA COLLEGE OF OPTOMETRY
Secondary Phone
8042261144107
Graduation Year
1996 (30 years ago)
PAC ID
6507023405
Group Practice PAC ID
4385711191
Professional Enrollment ID
I20120203000768
Address ID
VA232312713RI4811XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,052 OPTOMETRY in VA

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Provider Addresses for DR. KENNETH BRYCE GORDON (OD)

  • Laburnum Avenue, Casino, Richmond Valley Council, New South Wales, 2470, Australia

    RICHMOND, VA 232312713

    Phone: (804) 226-1144

    Fax: (804) 236-9026

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 24 Open Payments records for all available years, with a total value of $550.

Total Amount is formed as General ($550) + Research ($0) + Ownership ($0) = $550.

Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($394).

Total Amount

$550

General + Research + Ownership

Payments

24

Total payment records

General Amount

$550

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-17

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-02-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120203000768IOptometryVATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92014Established patient complete exam of visual system264261$0
92012Established patient problem focused exam of visual system6248$0
92133Imaging of optic nerve4034$0
92004New patient complete exam of visual system3737$0
92250Photography of the retina3535$0
View full utilization report →

Insurance plans in this area (ZIP 23231)

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Provider's Procedures

DR. KENNETH BRYCE GORDON (OD) performs procedures in OPTOMETRY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OPTOMETRYVA92012Eye and medical examination for diagnosis and treatment, established patient10483
OPTOMETRYVA92083Measurement of field of vision during daylight conditions3935
OPTOMETRYVA92134Diagnostic imaging of retina1615

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4385711191View full group profile
NameSpecialtyState
O P T O M E T R YVA
O P T O M E T R YCA
O P T O M E T R YVA

Reviews

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Frequently asked questions

Can I use this page to confirm DR. KENNETH BRYCE GORDON (OD)'s NPI?
Yes. DR. KENNETH BRYCE GORDON (OD) is listed with NPI 1497752208 in the public NPI dataset.
Is DR. KENNETH BRYCE GORDON (OD) listed as active for patients and plans?
The listing shows DR. KENNETH BRYCE GORDON (OD) as active in the NPI system.
What taxonomy line describes DR. KENNETH BRYCE GORDON (OD)?
For research purposes, treat DR. KENNETH BRYCE GORDON (OD) as Optometrist in this dataset. Clinical services aligned with this taxonomy classification.
Where is DR. KENNETH BRYCE GORDON (OD) based?
DR. KENNETH BRYCE GORDON (OD) is tied to Richmond, Virginia in the data we show; additional addresses may exist on the full record.
Is the information about DR. KENNETH BRYCE GORDON (OD) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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