RICKELL GORDON NURSE PRACTITIONER
NPI 1093132052
Nurse Practitioner - Family in Rochester, NY
About Rickell Gordon Nurse Practitioner NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RICKELL GORDON NURSE PRACTITIONER (NPI 1093132052) is an individual family provider in Rochester, New York, licensed in New York (345491) and active in the NPI registry since March 2014. She is enrolled in Medicare PECOS, is affiliated with Rochester General Hospital, and is a graduate of Other (2019).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Rickell Gordon Nurse Practitioner is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
3Medicare enrollment records show Rickell Gordon reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Rochester, NY 14622
- Reassigned Medicare billing, New York enrollment
- 2 clinicians in this Medicare group
Staten Island, NY 10314
- Reassigned Medicare billing, New York enrollment
- 43 clinicians in this Medicare group
Brooklyn, NY 11229
- Reassigned Medicare billing, New York enrollment
- 72 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Rochester General Hospital
Acute Care Hospitals · Rochester, NYPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 14613 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
ROCHESTER, NY 14613
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Rickell Gordon's NPI number?
The NPI number for Rickell Gordon is 1093132052. It was assigned to this individual provider in the NPPES registry on March 27, 2014.
Where is Rickell Gordon located?
Rickell Gordon practices at 528 Augustine St, Rochester, NY 14613. The listed phone number is (585) 733-0433.
What is Rickell Gordon's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Rickell Gordon enrolled in Medicare?
Yes. Rickell Gordon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Rickell Gordon's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Rickell Gordon reassigns Medicare benefits to 3 organizations: (Rochester, NY), Rd Medical Professional Services PC (Staten Island, NY) and Ilm Medical Care PLLC (Brooklyn, NY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Rickell Gordon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Rickell Gordon affiliated with any hospitals?
According to CMS data, Rickell Gordon is affiliated with Rochester General Hospital.
When was this NPI record last updated?
The NPPES record for Rickell Gordon was last updated on May 7, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Rickell Gordon, NURSE PRACTITIONER · NPI 1093132052
Family physician in Rochester, New York. Individual provider, active in the CMS NPPES registry since March 27, 2014.
## Identity
- **NPI:** 1093132052 (Entity type: Individual)
- **Enumerated:** March 27, 2014
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 345491 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 528 AUGUSTINE ST, Rochester, NY 14613-1335
- **Phone:** (585) 733-0433
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): (NPI 1801841556, Rochester, NY); Rd Medical Professional Services PC (NPI 1811643166, Staten Island, NY); Ilm Medical Care PLLC (NPI 1023442035, Brooklyn, NY) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** May 7, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1093132052) · Data from the CMS NPPES public registry.