TISHA C. GORDON (CRNA) – Certified Registered Nurse Anesthetist, NPI 1720310253

TISHA C. GORDON (CRNA) is a healthcare provider. based in Sandy, Utah. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 354490-4406 (UT). The NPI Number for TISHA C. GORDON (CRNA) is 1720310253

Main info

Female
17 Years Of Experience
Accepts Medicare Assignment
Name
TISHA C. GORDON (CRNA)
NPI
1720310253
Phone
(801) 432-2600
Address
10150 CENTENNIAL PKWY
Enumeration Date
9 February 2010
Last Update Date
9 February 2010

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4699987443
Graduation Year
2009 (17 years ago)
PAC ID
7618002767
Group Practice PAC ID
9537584313
Professional Enrollment ID
I20100316000110
Address ID
UT844056905OG5475X500X300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:16State licenses:1Digital endpointsOther names

265 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in UT

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Provider Addresses for TISHA C. GORDON (CRNA)

  • 10150, Centennial Parkway, Little Willow, Sandy, Salt Lake County, Utah, 84070, United States

    SUITE 230

    SANDY, UT 840704103

    Phone: (801) 432-2600

    Fax: (801) 432-2668

    Type: Mailing

  • North 1100 East, American Fork, Utah County, Utah, 84062, United States

    AMERICAN FORK, UT 840032096

    Phone: (801) 763-3300

    Fax: (801) 432-2668

    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: 2010-03-16

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
I20100316000110ICertified Registered Nurse Anesthetist (Crna)UTTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00812Anesthesia for exam of colon using an endoscope1717$0
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope1111$0
View full utilization report →

Insurance plans in this area (ZIP 84070)

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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: 9537584313View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)UT
A N E S T H E S I O L O G YUT
Certified Registered Nurse Anesthetist (Crna)UT
Certified Registered Nurse Anesthetist (Crna)UT
A N E S T H E S I O L O G YIL
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)UT
A N E S T H E S I O L O G YUT
Certified Registered Nurse Anesthetist (Crna)UT

Reviews

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Frequently asked questions

Is TISHA C. GORDON (CRNA) listed with a National Provider Identifier?
Yes — TISHA C. GORDON (CRNA) has NPI 1720310253 on file in the registry.
Active or inactive — what applies to TISHA C. GORDON (CRNA)?
You should see TISHA C. GORDON (CRNA) as active in CMS-hosted NPPES data.
What area of care is associated with TISHA C. GORDON (CRNA)?
TISHA C. GORDON (CRNA)'s record emphasizes Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Is TISHA C. GORDON (CRNA) associated with Sandy?
Public fields place TISHA C. GORDON (CRNA) around Sandy, Utah. Always confirm the exact site before visiting.
Does TISHA C. GORDON (CRNA) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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