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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DOMINIQUE S GORDON FNP-C, PMHNP-BC
NPI 1982204178
Nurse Practitioner - Psychiatric/Mental Health in Palm Bay, FL

Active since October 28, 2020PECOS Enrolled
3425 BAYSIDE LAKES BLVD SE STE 103, PALM BAY, FL 32909(321) 557-3065 Get Directions Write a Review

NPPES record last updated: July 10, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 10, 2026, Nov 6, 2025, Nov 8, 2023 and 6 more (9 updates tracked since 2020).

About Dominique S Gordon Fnp-c, Pmhnp-bc NPPES

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

DOMINIQUE S GORDON FNP-C, PMHNP-BC (NPI 1982204178) is an individual psychiatric/mental health provider in Palm Bay, Florida, licensed in Florida (APRN11014427) and active in the NPI registry since October 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1982204178
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameDOMINIQUE S GORDONCredential: FNP-C, PMHNP-BC
Location Address3425 BAYSIDE LAKES BLVD SE STE 103Palm Bay, FL 32909-6867
Mailing Address3425 Bayside Lakes Blvd Se Ste 103Palm Bay, FL 32909-6867 · (321) 364-1094
Phone(321) 557-3065
Sole ProprietorYes
Enumeration DateOctober 28, 2020
Last NPPES UpdateJuly 10, 20269 updates tracked since enumeration
NPPES CertifiedJuly 10, 2026
✔ NPI 1982204178 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in FL · APRN11014427
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License APRN11014427 (FL)
3425 BAYSIDE LAKES BLVD SE STE 103, Palm Bay, FL 32909
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dominique S Gordon Fnp-c, Pmhnp-bc 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32909 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
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.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BYRON LOVING LITTLE ANGELS LLC
Non-emergency Medical Transport (VAN)
3425 BAYSIDE LAKES BLVD SE STE 103
PALM BAY, FL 32909
Brevard County (678) 672-9948
THAT'S SO VEIN
Technician, Pathology (Phlebotomy)
3425 BAYSIDE LAKES BLVD SE STE 103
PALM BAY, FL 32909
Brevard County (321) 730-2091
DIVERSIFY RELIABLE TRANSPORTATION LLC
Non-emergency Medical Transport (VAN)
3425 BAYSIDE LAKES BLVD SE STE 103
PALM BAY, FL 32909
Brevard County (321) 398-2143

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 Dominique Gordon's NPI number?

The NPI number for Dominique Gordon is 1982204178. It was assigned to this individual provider in the NPPES registry on October 28, 2020.

Where is Dominique Gordon located?

Dominique Gordon practices at 3425 Bayside Lakes Blvd SE Ste 103, Palm Bay, FL 32909. The listed phone number is (321) 557-3065.

What is Dominique Gordon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Dominique Gordon enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Dominique Gordon was last updated on July 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 28 days 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.