Michael D Gordon, APRN is a medicare enrolled "Clinical Nurse Specialist - Adult Health" in Benton, Kentucky. His current practice location is
373 Breezeel School Rd, Benton, Kentucky. You can reach out to his office (for appointments etc.) via phone at
(307) 247-3661.
Michael D Gordon is licensed to practice in Kentucky (license number 3011246) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1225562622.
Provider's Profile
| Full Name | Michael D Gordon |
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| Gender | Male |
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| Speciality | Clinical Nurse Specialist - Adult Health |
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| Location | 373 Breezeel School Rd, Benton, Kentucky |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1225562622
- Provider Enumeration Date: 04/12/2017
- Last Update Date: 10/21/2021
Medicare PECOS Information:
- PECOS PAC ID: 6406116300
- Enrollment ID: I20180605000558
Medical Identifiers
Medical identifiers for Michael D Gordon such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1225562622 | NPI | - | NPPES |
| 7100515830 | Medicaid | KY | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 364SA2200X | Clinical Nurse Specialist - Adult Health | 3011246 (Kentucky) | Primary |
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. Michael D Gordon allows following entities to bill medicare on his behalf.
| Entity Name | Drynachan Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1891044657
PECOS PAC ID: 2264718824
Enrollment ID: O20170829004360 |
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| Entity Name | Vitae Health Medical Kentucky, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1629600879
PECOS PAC ID: 3173952637
Enrollment ID: O20200403001181 |
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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. Michael D 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 |
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Michael D Gordon, APRN
373 Breezeel School Rd,
Benton, KY 42025-5376
Ph: (270) 703-7320 | Michael D Gordon, APRN
373 Breezeel School Rd,
Benton, KY 42025-5376
Ph: (307) 247-3661 |
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