Lisa A Gordon, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PAT9104218 Issued in FL

Practice address

4361 Peacock Rd
Spring Hill, FL 34608-3551

Phone

(207) 745-8039

NPI assigned

Jul 19, 2007

Last updated

Apr 14, 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mobile Visiting Practitioners, LLCGroup PAC ID 7810239100, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Mobile Visiting Practitioners, LLC

  • Primary Care Nurse Practitioner
  • Daytona Beach, FL
  • NPI 1265915359
  Medicare reassignment Care Compare group
• Behavioral Health Services of Florida LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Daytona Beach, FL
  • NPI 1619649217
  NPD (past)
• Sebasticook Valley Health

  • Critical Access Hospital
  • Pittsfield, ME
  • NPI 1457461477
  NPD (past)

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1952501959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4361 PEACOCK RD",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346083551",
            "telephone_number": "207-745-8039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4361 PEACOCK RD",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346083551",
            "telephone_number": "207-745-8039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "LISA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-19",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA001182",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PAT9104218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Good Shepherd Medical Clinic PA
• Good Shepherd Medical Clinic PA
• Good Shepherd Medical Clinic PA
• Good Shepherd Medical Clinic PA
• Good Shepherd Medical Clinic PA
• Diana Maria Gourdet, DO
• Sarah Louise Graham-McCall, PA-C
• Laura Graham, ARNP
• Dawn Gray
• Micheline Gray, LCSW

• Physician Assistant in Spring Hill, FL
• Providers in Spring Hill, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.