LISA GORDON (PA) – Surgical Physician Assistant, NPI 1235382714

LISA GORDON (PA) is a healthcare provider. based in Boston, Massachusetts. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. PA1249 (MA). The NPI Number for LISA GORDON (PA) is 1235382714

Main info

Female
26 Years Of Experience
Name
LISA GORDON (PA)
NPI
1235382714
Phone
(617) 636-5000
Address
800 WASHINGTON ST
Enumeration Date
29 October 2008
Last Update Date
22 January 2016

Doctor Profile

Medical School Name
HAHNEMANN UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
6176365000
Graduation Year
2000 (26 years ago)
PAC ID
6103984927
Group Practice PAC ID
7618295437
Professional Enrollment ID
I20081023000418
Address ID
MA021111552BO800XXSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:17State licenses:1Digital endpointsOther names

5,131 PHYSICIAN ASSISTANT in MA

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Provider Addresses for LISA GORDON (PA)

  • Tufts Medical Center, 800, Washington Street, Chinatown, Financial District, Boston, Suffolk County, Massachusetts, 02111, United States

    BOSTON, MA 021111552

    Phone: (617) 636-5000

    Mailing address matches the actual address.

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: 2008-10-23

PECOS data refreshed: 2026-06-15

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
I20081023000418IPhysician AssistantMATBD

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 02111)

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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: 7618295437View full group profile
NameSpecialtyState
Hand SurgeryMA
Physician AssistantMA
P O D I A T R YMA
Orthopedic SurgeryTX
Physician AssistantMA
Physician AssistantNY
Physician AssistantMA
Physician AssistantME
Orthopedic SurgeryPA
Orthopedic SurgeryMA

Reviews

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Frequently asked questions

What unique ID ties claims to LISA GORDON (PA)?
NPI 1235382714 is assigned to LISA GORDON (PA) under the national enumeration system.
Is LISA GORDON (PA) active in the national directory?
LISA GORDON (PA)'s public NPI profile is in an active state.
What kind of provider is LISA GORDON (PA)?
The page reflects Surgical Physician Assistant for LISA GORDON (PA). Clinical services aligned with this taxonomy classification.
Where does public data place LISA GORDON (PA)?
The snapshot lists Boston, Massachusetts for LISA GORDON (PA); download NPPES for the complete set.
Is LISA GORDON (PA) a real provider?
This page reflects official NPPES data for NPI 1235382714. Always confirm identity and privileges with the practice and licensing boards.

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