Jessica Baker-Gordon

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

406871 Issued in NY

Practice address

640 Gazzola Dr
East Patchogue, NY 11772-4952

Phone

(347) 351-4437

NPI assigned

Mar 19, 2025

Last updated

Mar 23, 2025By the provider in NPPES

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 NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

• New York City Health and Hospitals Corporation

  dba Gouverneur Healthcare Services

  • Clinic/Center
  • New York, NY
  • NPI 1548208127
  Medicare reassignment

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

{
    "created_epoch": "1742342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742688000000",
    "number": "1912707779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 GAZZOLA DR",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 GAZZOLA DR",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724952",
            "telephone_number": "347-351-4437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER-GORDON",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-19",
        "last_updated": "2025-03-23",
        "certification_date": "2025-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "406871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian W Ault, DO, MS
• Scott Thomas Avery, PT
• Ethan Winslow Ayres, MD, MPH
• Dean J Babich, MD
• Reshma Baboolal
• Shari V Baker
• Donna Lynne Ball, LMT
• Eric Baranek, M.D.
• Stephanie Basant, MD
• Jessica Bass, LPN

• Psychiatric/Mental Health Nurse Practitioner in East Patchogue, NY
• Providers in East Patchogue, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2025; 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.