DR. NICANDA NORRIE GORDON (MD) – Family Medicine Physician, NPI 1043954472

DR. NICANDA NORRIE GORDON (MD) is a healthcare provider. based in Cutler bay, Florida. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. ME171445 (FL). The NPI Number for DR. NICANDA NORRIE GORDON (MD) is 1043954472

Main info

Male
Sole Proprietor
8 Years Of Experience
Accepts Medicare Assignment
Name
DR. NICANDA NORRIE GORDON (MD)
NPI
1043954472
Phone
Not provided
Address
10300 SW 216TH ST
Enumeration Date
21 April 2022
Last Update Date
3 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5612725373
Graduation Year
2018 (8 years ago)
PAC ID
6608380555
Group Practice PAC ID
3870633753
Professional Enrollment ID
I20250710003111
Address ID
FL334444034DE237XXBLVD400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness85
Years active:4State licenses:1Digital endpointsOther names

6,722 FAMILY PRACTICE in FL

Provider Addresses for DR. NICANDA NORRIE GORDON (MD)

  • 10300 SW 216TH ST

    CUTLER BAY, FL 331901003

    Phone:

    Type: Mailing

  • 1001 NW 13TH ST STE 201

    BOCA RATON, FL 334862269

    Phone: (561) 955-6663

    Fax: (561) 955-2897

    Type: Mailing

  • 237 GEORGE BUSH BLVD

    DELRAY BEACH, FL 334444034

    Phone: (561) 272-5373

    Fax: (833) 625-1627

    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.

This can happen when there are no reportable CMS Open Payments records.

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: 2025-07-10

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250710003111IFamily PracticeFLTBD

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.

Verify on CMS Revalidation Lookup Tool

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 33190)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3870633753View full group profile
NameSpecialtyState
-FL
Physician AssistantFL
-FL
Physician AssistantFL
Physician AssistantFL
G A S T R O E N T E R O L O G YMA
U R O L O G YIA
-FL
Nurse PractitionerFL
Internal MedicineFL

Reviews

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Frequently asked questions

Is DR. NICANDA NORRIE GORDON (MD) listed with a National Provider Identifier?
Yes — DR. NICANDA NORRIE GORDON (MD) has NPI 1043954472 on file in the registry.
Is there an active status for DR. NICANDA NORRIE GORDON (MD)?
For scheduling context, DR. NICANDA NORRIE GORDON (MD) is shown as active in the registry.
How would a patient describe DR. NICANDA NORRIE GORDON (MD)'s focus?
For DR. NICANDA NORRIE GORDON (MD), the primary taxonomy reads as Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is DR. NICANDA NORRIE GORDON (MD) associated with Cutler Bay?
Public fields place DR. NICANDA NORRIE GORDON (MD) around Cutler Bay, Florida. Always confirm the exact site before visiting.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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