Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mara Gordon

Individual provider Physician Assistant · NPI 1679399562

Mara Gordon is a Physician Assistant in Detroit, Michigan. Qualified in 2025, 1 year ago. Works from 3 locations. Licensed in Michigan.

Years since qualifying
1
Licensed in
MI
In the registry since
2024
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Practice location Address checks out

259 Mack Ave
Detroit, MI 48201-2427
Phone: (313) 577-1716
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 43900 Garfield Rd Ste 100, Clinton Township, MI 48038-1137 — (586) 286-0112
  • 43900 Garfield Rd Ste 121, Clinton Township, MI 48038-1137 — (586) 286-0112

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601013165 (MI)

Record details

NPI number1679399562
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 25, 2024
Last updated in NPPESMay 5, 2026
Certification dateMay 5, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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