JEREMY M GORDON DC PA
NPI 1669562500
Clinic/Center - Multi-Specialty in Deland, FL
About Jeremy M Gordon Dc Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JEREMY M GORDON DC PA (NPI 1669562500) is a healthcare organization registered as a multi-specialty in Deland, Florida and active in the NPI registry since October 2006. The organization lists Jeremy M Gordon, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jeremy M Gordon Dc Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Jeremy M Gordon Dc PA, which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Jeremy M Gordon Dc PA's NPI number?
The NPI number for Jeremy M Gordon Dc PA is 1669562500. It was assigned to this organization in the NPPES registry on October 13, 2006.
Where is Jeremy M Gordon Dc PA located?
Jeremy M Gordon Dc PA is located at 905 N Stone St, Deland, FL 32720. The listed phone number is (386) 734-9995.
What is Jeremy M Gordon Dc PA's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.
Is Jeremy M Gordon Dc PA enrolled in Medicare?
Yes. Jeremy M Gordon Dc PA is registered in the Medicare PECOS enrollment system.
When is Jeremy M Gordon Dc PA's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Florida, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Jeremy M Gordon Dc PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians, all in Chiropractic, reassign their Medicare billing to Jeremy M Gordon Dc PA. A 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 the clinician's services. Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Jeremy M Gordon Dc PA accept?
Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Wellpoint list Jeremy M Gordon Dc PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Jeremy M Gordon Dc PA was last updated on October 29, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.
# Jeremy M Gordon Dc Pa · NPI 1669562500
Multi-Specialty organization in Deland, Florida. Organization record, active in the CMS NPPES registry since October 13, 2006.
## Identity
- **NPI:** 1669562500 (Entity type: Organization)
- **Enumerated:** October 13, 2006
- **Primary specialty:** Clinic/Center - Multi-Specialty · taxonomy 261QM1300X
- **Organization subpart:** No
- **Authorized official:** Jeremy Gordon, PRESIDENT
## Practice location
- **Address:** 905 N STONE ST, Deland, FL 32720-2521
- **Phone:** (386) 734-9995 · **Fax:** (386) 734-9949
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, Florida, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 4 clinicians (Chiropractic) reassign Medicare billing to this organization (form CMS-855R); 4 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 29, 2010
- **Other identifiers:** Other 55875 (FL); Medicare ID-Type Unspecified 55875Z (FL)
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Source: [NPI Profile](https://npiprofile.com/npi/1669562500) · Data from the CMS NPPES public registry.