DR. DUSTIN GORDON (DC) – Chiropractor, NPI 1659082964

DR. DUSTIN GORDON (DC) is a healthcare provider. based in Sapulpa, Oklahoma. specializing in CHIROPRACTIC. They hold the professional credentials DC. They hold a License No. 4515 (OK). The NPI Number for DR. DUSTIN GORDON (DC) is 1659082964

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
DR. DUSTIN GORDON (DC)
NPI
1659082964
Phone
(918) 691-6885
Address
11515 W 91ST ST S
Enumeration Date
7 December 2022
Last Update Date
7 December 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9186224782
Graduation Year
2022 (4 years ago)
PAC ID
2264807619
Group Practice PAC ID
1557883162
Professional Enrollment ID
I20230417002119
Address ID
OK741322827TU8660XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

498 CHIROPRACTIC in OK

Provider Addresses for DR. DUSTIN GORDON (DC)

  • 11515 W 91ST ST S

    SAPULPA, OK 740668422

    Phone: (918) 691-6885

    Type: Mailing

  • 609 E MAIN ST

    JENKS, OK 740374138

    Phone: (918) 299-1296

    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: 2023-04-17

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
I20230417002119IChiropracticOKTBD

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 74066)

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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: 1557883162View full group profile
NameSpecialtyState
Nurse PractitionerOK
Family PracticeOK
Nurse PractitionerOK

Reviews

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Frequently asked questions

What is the registry number for DR. DUSTIN GORDON (DC)?
The registry entry for DR. DUSTIN GORDON (DC) shows NPI 1659082964.
Should I treat DR. DUSTIN GORDON (DC) as an active provider?
Patients and plans typically see DR. DUSTIN GORDON (DC) as active in the national extract.
Which specialty label fits DR. DUSTIN GORDON (DC)?
NPPES ties DR. DUSTIN GORDON (DC) to Chiropractor in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to DR. DUSTIN GORDON (DC)?
DR. DUSTIN GORDON (DC) is associated with Sapulpa, Oklahoma in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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