Dr Kenyetta Michelle Gordon, MD - Medicare Family Medicine in Crescent City, CA

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Dr Kenyetta Michelle Gordon, MD is a medicare enrolled "Family Medicine" physician in Crescent City, California. Her current practice location is 1675 Northcrest Dr, Crescent City, California. You can reach out to her office (for appointments etc.) via phone at (707) 464-2750.

Dr Kenyetta Michelle Gordon is licensed to practice in California (license number C186176) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1013101161.

Contact Information

Dr Kenyetta Michelle Gordon, MD
1675 Northcrest Dr,
Crescent City, CA 95531-8928
(707) 464-2750
Not Available

Map and Direction




Physician's Profile

Full NameDr Kenyetta Michelle Gordon
GenderFemale
SpecialityFamily Medicine
Location1675 Northcrest Dr, Crescent City, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1013101161
  • Provider Enumeration Date: 08/31/2007
  • Last Update Date: 05/26/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 3870786676
  • Enrollment ID: I20101026000025

Medical Identifiers

Medical identifiers for Dr Kenyetta Michelle Gordon such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1013101161NPI-NPPES
1013101161MedicaidNV

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 19863 (Nevada)Secondary
207Q00000XFamily Medicine E-6423 (Arkansas)Secondary
207Q00000XFamily Medicine C186176 (California)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Kenyetta Michelle Gordon allows following entities to bill medicare on her behalf.
Entity NameTexarkana Behavioral Associates Lc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1467483677
PECOS PAC ID: 9436062379
Enrollment ID: O20040223000353
Entity NameSouth Arkansas Emergency Physicians Llp
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1942435458
PECOS PAC ID: 4486705720
Enrollment ID: O20090629000005
Entity NameHospital Care Consultants Of Fordyce Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1316497464
PECOS PAC ID: 5395024475
Enrollment ID: O20161112000042
Entity NameEss Of Fordyce Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1821547977
PECOS PAC ID: 1254611601
Enrollment ID: O20161201001070

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kenyetta Michelle Gordon is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Kenyetta Michelle Gordon, MD
1600 Weeot Way,
Arcata, CA 95521-4734

Ph: () -		Dr Kenyetta Michelle Gordon, MD
1675 Northcrest Dr,
Crescent City, CA 95531-8928

Ph: (707) 464-2750

Reviews and Comments


Family Medicine Doctors in Crescent City, CA

Dr. James A Morrow, D.O.
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 1675 Northcrest Dr, Crescent City, CA 95531
Phone: 707-464-6700    
Dr. Michael Clifton Sayre, M.D.
Family Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 5909 Lake Earl Drive, Pelican Bay State Prison, Crescent City, CA 95531
Phone: 707-465-9197    
Kevin John Caldwell, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1240 Marshall St, Crescent City, CA 95531
Phone: 707-465-5566    Fax: 707-465-4990
Donna Sund, DO
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1240 Marshall St, Crescent City, CA 95531
Phone: 707-465-5566    Fax: 707-465-4990
Dr. Claire Price Williams Iii, MD
Family Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 5905 Lake Earl Dr, Crescent City, CA 95532
Phone: 707-465-1000    
Dr. Michelle Marie Keeter, MD
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 550 E Washington Blvd, Crescent City, CA 95531
Phone: 707-465-6925    Fax: 707-465-6070

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.