Dr Shayna Lee Gordon, MD is a medicare enrolled "Dermatology - Mohs-micrographic Surgery" physician in Plainfield, Indiana. She went to Indiana University School Of Medicine and graduated in 2012 and has 12 years of diverse experience with area of expertise as Dermatology. She is a member of the group practice Optima Dermatology Llc and her current practice location is
824 Edwards Dr, Plainfield, Indiana. You can reach out to her office (for appointments etc.) via phone at
(317) 406-3254.
Dr Shayna Lee Gordon is licensed to practice in Indiana (license number 01078403A) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1679849780.
Physician's Profile
Full Name | Dr Shayna Lee Gordon |
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Gender | Female |
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Speciality | Dermatology |
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Experience | 12 Years |
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Location | 824 Edwards Dr, Plainfield, Indiana |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Dr Shayna Lee Gordon attended and graduated from Indiana University School Of Medicine in 2012
NPI Data:
- NPI Number: 1679849780
- Provider Enumeration Date: 03/23/2012
- Last Update Date: 01/31/2024
Medicare PECOS Information:
- PECOS PAC ID: 4880823038
- Enrollment ID: I20170822001642
Medical Identifiers
Medical identifiers for Dr Shayna Lee Gordon such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1679849780 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207ND0101X | Dermatology - Mohs-micrographic Surgery | 01078403A (Indiana) | Primary |
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Optima Dermatology Llc | 3971561648 | 47 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Shayna Lee Gordon allows following entities to bill medicare on her behalf.
Entity Name | Dermatology Center Of Indiana Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1033199138 PECOS PAC ID: 0941386999 Enrollment ID: O20080401000053 |
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Entity Name | Optima Dermatology Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1831187764 PECOS PAC ID: 3971561648 Enrollment ID: O20230823002407 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Shayna Lee Gordon is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Shayna Lee Gordon, MD 111 New Hampshire Ave Ste 2, Portsmouth, NH 03801-2864 Ph: (802) 909-2053 | Dr Shayna Lee Gordon, MD 824 Edwards Dr, Plainfield, IN 46168-2791 Ph: (317) 406-3254 |
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