Mrs Danielle Alexis Gordon, FNP is a medicare enrolled "Nurse Practitioner - Family" physician in Imperial Beach, California. She graduated from medical school in 2018 and has 6 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Innovative Wellness Clinic Inc A Nursing Corporation and her current practice location is
705 Palm Ave, Imperial Beach, California. You can reach out to her office (for appointments etc.) via phone at
(619) 423-3774.
Mrs Danielle Alexis Gordon is licensed to practice in California (license number NP95010963) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1780148056.
Physician's Profile
| Full Name | Mrs Danielle Alexis Gordon |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 6 Years |
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| Location | 705 Palm Ave, Imperial Beach, California |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mrs Danielle Alexis Gordon graduated from medical school in 2018
NPI Data:
- NPI Number: 1780148056
- Provider Enumeration Date: 01/30/2019
- Last Update Date: 05/12/2020
Medicare PECOS Information:
- PECOS PAC ID: 7517379233
- Enrollment ID: I20201221002498
Medical Identifiers
Medical identifiers for Mrs Danielle Alexis Gordon such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1780148056 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | 95010963 (California) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | NP95010963 (California) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Innovative Wellness Clinic Inc A Nursing Corporation | 9830587427 | 2 |
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. Mrs Danielle Alexis Gordon allows following entities to bill medicare on her behalf.
| Entity Name | Centro De Salud De La Comunidad De San Ysidro, Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1124782685
PECOS PAC ID: 6901709435
Enrollment ID: O20040130000711 |
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| Entity Name | Innovative Wellness Clinic Inc A Nursing Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1316535776
PECOS PAC ID: 9830587427
Enrollment ID: O20211101002777 |
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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. Mrs Danielle Alexis 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 Address | Practice Location Address |
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Mrs Danielle Alexis Gordon, FNP
1244 El Cortez Ct,
Chula Vista, CA 91910-8186
Ph: (904) 631-2880 | Mrs Danielle Alexis Gordon, FNP
705 Palm Ave,
Imperial Beach, CA 91932-1229
Ph: (619) 423-3774 |
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