Tiffany Dawn Gordon, NP is a medicare enrolled "Nurse Practitioner - Family" in Le Sueur, Minnesota. Her current practice location is
625 S 4th St Ste A, Le Sueur, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(507) 593-5920.
Tiffany Dawn Gordon is licensed to practice in Minnesota (license number 9339) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1992424675.
Provider's Profile
| Full Name | Tiffany Dawn Gordon |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 625 S 4th St Ste A, Le Sueur, Minnesota |
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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: 1992424675
- Provider Enumeration Date: 08/25/2022
- Last Update Date: 08/25/2022
Medicare PECOS Information:
- PECOS PAC ID: 5395114201
- Enrollment ID: I20221216000476
Medical Identifiers
Medical identifiers for Tiffany Dawn Gordon such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1992424675 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 9339 (Minnesota) | 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. Tiffany Dawn Gordon allows following entities to bill medicare on her behalf.
| Entity Name | Minnesota Valley Health Center Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1730248907
PECOS PAC ID: 9032006507
Enrollment ID: O20040301000309 |
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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. Tiffany Dawn 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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Tiffany Dawn Gordon, NP
258 Arabian Ave E,
Shakopee, MN 55379-4701
Ph: (952) 564-8067 | Tiffany Dawn Gordon, NP
625 S 4th St Ste A,
Le Sueur, MN 56058-2203
Ph: (507) 593-5920 |
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