Shayna Lee Gordon, M.D.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

01078403A Issued in IN

Practice address

2800 S State Road 135 Ste 250
Greenwood, IN 46143-6223

Phone

(317) 300-1788

Fax

(317) 743-8103

NPI assigned

Mar 23, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Indiana University School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optima Dermatology LLCGroup PAC ID 3971561648, 74 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.65 of 100Reported as group

Promoting interoperability

89

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sgordon@dermindy.emadirect.md

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Optima Dermatology LLC

  • Dermatology Physician
  • Boardman, OH
  • NPI 1831187764

  IN, Mohs-Micrographic Surgery

  Medicare reassignment Care Compare group NPD
• Dermatology Center of Indiana PC

  • Dermatology Physician
  • Plainfield, IN
  • NPI 1033199138
  Medicare reassignment NPD
• Advanced Dermatology and Skin Cancer Center

  • Clinical Medical Laboratory
  • Boardman, OH
  • NPI 1497912893
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771977600000",
    "number": "1679849780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 NEW HAMPSHIRE AVE STE 2",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038012864",
            "telephone_number": "330-947-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 S STATE ROAD 135 STE 250",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461436223",
            "telephone_number": "317-300-1788",
            "fax_number": "317-743-8103"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 W 2nd St",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474032217",
            "country_code": "US",
            "telephone_number": "812-200-2458",
            "fax_number": "930-200-8590",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6639 Whitestown Pkwy",
            "address_purpose": "LOCATION",
            "city": "Zionsville",
            "state": "IN",
            "postal_code": "460777622",
            "country_code": "US",
            "telephone_number": "317-732-8980",
            "fax_number": "317-732-8979",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2155 E Main St",
            "address_purpose": "LOCATION",
            "city": "Plainfield",
            "state": "IN",
            "postal_code": "461681816",
            "country_code": "US",
            "telephone_number": "855-297-9689",
            "fax_number": "603-451-6001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "SHAYNA",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-23",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "IN",
            "license": "01078403A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gloria Goodman
• Victoria Goodrich
• Goodwill Industries of Central Indiana, Inc.
• Alexis Gordon, RBT
• Kobie Charles Gordon, DDS
• Kayla Gore
• David W Goris, DDS
• Jordan Alissa Gottschalk
• Carrie Michelle Gould, M.D.
• Michael Robert Gould, O.D.

• MOHS-Micrographic Surgery Physician in Greenwood, IN
• Providers in Greenwood, IN by specialty
• MOHS-Micrographic Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.