Daryl J Gordon, CRNP is a medicare enrolled "Nurse Practitioner - Family" in Jim Thorpe, Pennsylvania. He graduated from nursing school in 2009 and has 16 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice St Lukes Physician Group Inc and his current practice location is
1122 North St, Jim Thorpe, Pennsylvania. You can reach out to his office (for appointments etc.) via phone at
(484) 526-6545.
Daryl J Gordon is licensed to practice in Pennsylvania (license number SP010668) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1275863839.
Provider's Profile
| Full Name | Daryl J Gordon |
|---|
| Gender | Male |
|---|
| Speciality | Nurse Practitioner |
|---|
| Experience | 16 Years |
|---|
| Location | 1122 North St, Jim Thorpe, Pennsylvania |
|---|
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
|---|
Medical Education and Training:
- Daryl J Gordon graduated from nursing school in 2009
NPI Data:
- NPI Number: 1275863839
- Provider Enumeration Date: 01/05/2010
- Last Update Date: 09/29/2025
Medicare PECOS Information:
- PECOS PAC ID: 1456495217
- Enrollment ID: I20100217000122
Medical Identifiers
Medical identifiers for Daryl J Gordon such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1275863839 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363L00000X | Nurse Practitioner | SP010668 (Pennsylvania) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | SP010668 (Pennsylvania) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| St Lukes Physician Group Inc | 6709798333 | 1858 |
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. Daryl J Gordon allows following entities to bill medicare on his behalf.
| Entity Name | St Lukes Physician Group Inc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1700984622
PECOS PAC ID: 6709798333
Enrollment ID: O20040226000062 |
|---|
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. Daryl J 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 |
|---|
Daryl J Gordon, CRNP
1122 North St,
Jim Thorpe, PA 18229-1717
Ph: (484) 526-6545 | Daryl J Gordon, CRNP
1122 North St,
Jim Thorpe, PA 18229-1717
Ph: (484) 526-6545 |
Reviews and Comments