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CHANELLE GORDON FNP-C
NPI 1114462397
Nurse Practitioner - Family in Saint Albans, NY

Active since December 27, 2016PECOS Enrolled
11816 197TH ST, SAINT ALBANS, NY 11412(347) 752-8240 Get Directions Write a Review

NPPES record last updated: September 7, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 7, 2024, Dec 27, 2016 (2 updates tracked since 2016).

About Chanelle Gordon Fnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHANELLE GORDON FNP-C (NPI 1114462397) is an individual family provider in Saint Albans, New York, licensed in New York (354879) and active in the NPI registry since December 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114462397
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameCHANELLE GORDONCredential: FNP-C
Location Address11816 197TH STSaint Albans, NY 11412-3456
Mailing Address11816 197th StSaint Albans, NY 11412-3456 · (347) 752-8240
Phone(347) 752-8240
Sole ProprietorNo
Enumeration DateDecember 27, 2016
Last NPPES UpdateSeptember 7, 20242 updates tracked since enumeration
NPPES CertifiedSeptember 5, 2024
✔ NPI 1114462397 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NY · 354879
11816 197TH ST, Saint Albans, NY 11412
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Chanelle Gordon Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Chanelle Gordon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ny Med Of Brooklyn LLC
10 mi
Multi-Specialty
765 NOSTRAND AVE
Brooklyn, NY 11216
  • Reassigned Medicare billing, New York enrollment
  • 4 clinicians in this Medicare group
NPI 1457011140 (718) 263-3500

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11412 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$104.17 typical visit price
range $67.00 – $201.98
Typical copayment $26.04 (range $16.75 – $50.49)
Most-billed visit code 99203
Established Patient
$116.96 typical visit price
range $21.62 – $163.52
Typical copayment $29.24 (range $5.40 – $40.88)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Chanelle Gordon's NPI number?

The NPI number for Chanelle Gordon is 1114462397. It was assigned to this individual provider in the NPPES registry on December 27, 2016.

Where is Chanelle Gordon located?

Chanelle Gordon practices at 11816 197th St, Saint Albans, NY 11412. The listed phone number is (347) 752-8240.

What is Chanelle Gordon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Chanelle Gordon enrolled in Medicare?

Yes. Chanelle Gordon is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Chanelle Gordon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Chanelle Gordon reassigns Medicare benefits to Ny Med Of Brooklyn LLC (Brooklyn, NY). The 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 Chanelle Gordon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Chanelle Gordon was last updated on September 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.