DR. DEVON CORDELIA GORDON-LYLES AGPNP-BC, CCRN
NPI 1750120408
Nurse Practitioner - Adult Health in Teaneck, NJ

Q: What is Devon Gordon-lyles's NPI number?

The NPI number for Devon Gordon-lyles is 1750120408. It was assigned to this individual provider in the NPPES registry on May 22, 2024.

Q: What is Devon Gordon-lyles's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Active since May 22, 2024PECOS Enrolled

157 SHEPARD AVE, TEANECK, NJ 07666(201) 937-6516 Get Directions Write a Review

NPPES record last updated: March 27, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Dr. Devon Cordelia Gordon-lyles Agpnp-bc, Ccrn NPPES

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

DR. DEVON CORDELIA GORDON-LYLES AGPNP-BC, CCRN (NPI 1750120408) is an individual adult health provider in Teaneck, New Jersey, licensed in New York (F311813-01) and active in the NPI registry since May 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1750120408

Entity TypeIndividualFemale

Primary Taxonomy363LA2200X

Provider Legal NameDR. DEVON CORDELIA GORDON-LYLESCredential: AGPNP-BC, CCRN

Location Address157 SHEPARD AVETeaneck, NJ 07666-6157

Mailing Address157 Shepard AveTeaneck, NJ 07666-6157 · (201) 937-6516

Phone(201) 937-6516

Sole ProprietorYes

Enumeration DateMay 22, 2024

Last NPPES UpdateMarch 27, 2025

NPPES CertifiedMarch 27, 2025

✔ NPI 1750120408 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in NY · F311813-01

Also ListedNurse PractitionerTaxonomy 363L00000X · License 26NJ15075500 (NJ)

157 SHEPARD AVE, Teaneck, NJ 07666

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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)

Dr. Devon Cordelia Gordon-lyles Agpnp-bc, Ccrn 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 Devon Gordon-lyles reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Icahn School Of Medicine At Mount Sinai

8.0 mi

Infectious Disease

1 GUSTAVE L LEVY PL
New York, NY 10029

Reassigned Medicare billing, New York enrollment
769 clinicians in this Medicare group

NPI 1659639524 (212) 987-3100

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 07666 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

$98.09 typical visit price

range $63.84 – $190.92

Typical copayment $24.52 (range $15.96 – $47.73)

Most-billed visit code 99203

Established Patient

$111.57 typical visit price

range $20.97 – $155.92

Typical copayment $27.89 (range $5.24 – $38.98)

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 Devon Gordon-lyles's NPI number?

The NPI number for Devon Gordon-lyles is 1750120408. It was assigned to this individual provider in the NPPES registry on May 22, 2024.

Where is Devon Gordon-lyles located?

Devon Gordon-lyles practices at 157 Shepard Ave, Teaneck, NJ 07666. The listed phone number is (201) 937-6516.

What is Devon Gordon-lyles's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Is Devon Gordon-lyles enrolled in Medicare?

Yes. Devon Gordon-lyles is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Devon Gordon-lyles's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Devon Gordon-lyles reassigns Medicare benefits to Icahn School Of Medicine At Mount Sinai (New York, 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 Devon Gordon-lyles'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 Devon Gordon-lyles was last updated on March 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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.