MR. SCOTT S GORDON (PA) – Physician Assistant, NPI 1306003058

MR. SCOTT S GORDON (PA) is a healthcare provider. based in Fritch, Texas. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. PA01597 (TX). The NPI Number for MR. SCOTT S GORDON (PA) is 1306003058

Main info

Male
24 Years Of Experience
Accepts Medicare Assignment
Name
MR. SCOTT S GORDON (PA)
NPI
1306003058
Phone
(806) 857-2311
Address
700 WEST BROADWAY
Enumeration Date
20 May 2008
Last Update Date
13 June 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8068572311
Graduation Year
2002 (24 years ago)
PAC ID
8729329453
Group Practice PAC ID
0042303232
Professional Enrollment ID
I20190408000798
Address ID
TX790368754FR700XXSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

8,491 PHYSICIAN ASSISTANT in TX

Provider Addresses for MR. SCOTT S GORDON (PA)

  • 700 WEST BROADWAY

    PO BOX 1570

    FRITCH, TX 790361570

    Phone: (806) 857-2311

    Fax: (806) 857-9362

    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)

CMS reports 1 Open Payments records for all available years, with a total value of $125.

Total Amount is formed as General ($125) + Research ($0) + Ownership ($0) = $125.

Last reported payment date: 2024-03-20 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($125).

Total Amount

$125

General + Research + Ownership

Payments

1

Total payment records

General Amount

$125

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-03-20

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
GlaxoSmithKline, LLC.$125
View all Open Payments →|Open Payments Risk Radar →

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: 2019-04-08

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
I20190408000798IPhysician AssistantTXTBD

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 79036)

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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: 0042303232View full group profile
NameSpecialtyState
Nurse PractitionerTX
General SurgeryTX
Nurse PractitionerTX
O B S T E T R I C S/ G Y N E C O L O G YTX
Nurse PractitionerTX
Nurse PractitionerTX
Family PracticeTX
-TX
-TX
-TX

Reviews

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Frequently asked questions

What federal number belongs to MR. SCOTT S GORDON (PA)?
The federal identifier for MR. SCOTT S GORDON (PA) is NPI 1306003058.
Does this profile mean MR. SCOTT S GORDON (PA) is currently active?
Yes — MR. SCOTT S GORDON (PA) appears active in the national provider directory.
Does MR. SCOTT S GORDON (PA) list a primary specialty?
If you are matching referrals, note Physician Assistant for MR. SCOTT S GORDON (PA). Clinical services aligned with this taxonomy classification.
Does MR. SCOTT S GORDON (PA) practice in Texas?
You will see Fritch, Texas on file for MR. SCOTT S GORDON (PA) alongside any extra practice locations.
Is MR. SCOTT S GORDON (PA) a real provider?
This page reflects official NPPES data for NPI 1306003058. Always confirm identity and privileges with the practice and licensing boards.

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