EMMA ELIZABETH GORDON – Physician Assistant, NPI 1295549350

EMMA ELIZABETH GORDON is a healthcare provider. based in Okmulgee, Oklahoma. specializing in PHYSICIAN ASSISTANT. They hold a License No. 5461 (OK). The NPI Number for EMMA ELIZABETH GORDON is 1295549350

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
EMMA ELIZABETH GORDON
NPI
1295549350
Phone
(918) 591-5700
Address
1313 E 20TH ST
Enumeration Date
6 February 2025
Last Update Date
23 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9185915700
Graduation Year
2024 (2 years ago)
PAC ID
1951824705
Group Practice PAC ID
5698786226
Professional Enrollment ID
I20250402001149
Address ID
OK744476303OK1313XSTXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

1,797 PHYSICIAN ASSISTANT in OK

Provider Addresses for EMMA ELIZABETH GORDON

  • 1313 E 20TH ST

    OKMULGEE, OK 744476303

    Phone: (918) 591-5700

    Fax: (918) 756-4490

    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: 2025-04-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20250402001149IPhysician AssistantTXTBD
I20250402001374IPhysician AssistantOKTBD

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 74447)

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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: 5698786226View full group profile

Reviews

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Frequently asked questions

What number should I use to identify EMMA ELIZABETH GORDON for billing?
Administrative and clinical systems typically use NPI 1295549350 for EMMA ELIZABETH GORDON.
Should I treat EMMA ELIZABETH GORDON as an active provider?
Patients and plans typically see EMMA ELIZABETH GORDON as active in the national extract.
What services align with EMMA ELIZABETH GORDON's listing?
EMMA ELIZABETH GORDON's public classification highlights Physician Assistant. Clinical services aligned with this taxonomy classification.
Which community is linked to EMMA ELIZABETH GORDON?
EMMA ELIZABETH GORDON shows a connection to Okmulgee, Oklahoma in registry-derived data.
Who maintains EMMA ELIZABETH GORDON's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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