KELLY GORDON (M.D.) – Child & Adolescent Psychiatry Physician, NPI 1124446505
Child & Adolescent Psychiatry Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
607 PSYCHIATRY in CO
Provider Addresses for KELLY GORDON (M.D.)
13001 E. 17TH PLACE, CAMPUS BOX F546
BLDG. 500, ROOM E2322
AURORA, CO 80045
Phone:
Type: Mailing
13123 E 16th Ave
Aurora, CO 800457106
Phone: (720) 777-1234
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-10-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20191007000879 | I | Psychiatry | CO | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 80045)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Mental Health Counselor | WY | |
| Physician Assistant | TN | |
| Physician Assistant | TX | |
| Clinical Psychologist | IL | |
| Clinical Psychologist | VA | |
| Clinical Social Worker | CO | |
| Physician Assistant | CO | |
| Marriage And Family Therapist | CO | |
| Mental Health Counselor | TN | |
| Physician Assistant | NC |
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