CHARLES R GORDON, MD, PA – Neurological Surgery Physician, NPI 1659789964

CHARLES R GORDON, MD, PA is a healthcare provider. based in Tyler, Texas. specializing in Neurological Surgery Physician. The NPI Number for CHARLES R GORDON, MD, PA is 1659789964

Main info

Organization
Name
CHARLES R GORDON, MD, PA
NPI
1659789964
Phone
(903) 363-1550
Address
PO BOX 6605
Authorized Official
CHARLES GORDON OWNER M.D.
Enumeration Date
30 July 2014
Last Update Date
22 November 2022
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:11State licenses:0Digital endpointsOther names

Provider Addresses for CHARLES R GORDON, MD, PA

  • PO BOX 6605

    TYLER, TX 757116605

    Phone: (903) 363-1550

    Fax: (903) 595-1592

    Type: Mailing

  • 5016 GILMER RD

    LONGVIEW, TX 756049666

    Phone: (903) 653-1823

    Fax: (903) 653-1822

    Type: Location

  • 1809 W LOOP 281

    STE. 124

    LONGVIEW, TX 756042571

    Phone: (903) 363-1550

    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: 2016-01-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2023-10-31 (952 days ago).

Enrollment records

1

Earliest due date

2023-10-31

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
O20160125002338OMulti-Specialty - PhysicianTX2023-10-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

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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 75711)

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Reviews

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Frequently asked questions

What unique ID ties claims to CHARLES R GORDON, MD, PA?
NPI 1659789964 is assigned to CHARLES R GORDON, MD, PA under the national enumeration system.
Is CHARLES R GORDON, MD, PA's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does CHARLES R GORDON, MD, PA treat or focus on?
Patients typically see CHARLES R GORDON, MD, PA under the specialty Neurological Surgery Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for CHARLES R GORDON, MD, PA?
The page summarizes Tyler, Texas for CHARLES R GORDON, MD, PA; expand the address list for detail.
How can I contact CHARLES R GORDON, MD, PA?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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