Consuelo Elizabeth Chavez-Gomez, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

VUT006194 Issued in NY

Practice address

7508 37TH Ave
Jackson Heights, NY 11372-6538

Phone

(718) 476-1458

Fax

(718) 476-1462

NPI assigned

Nov 16, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 7

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Olivos Opticians Inc

  • Eyewear Supplier
  • Jackson Heights, NY
  • NPI 1922237866
  Medicare reassignment NPD

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362096000000",
    "number": "1013080415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7508 37TH AVE",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113726538",
            "telephone_number": "718-476-1458",
            "fax_number": "718-476-1462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7508 37TH AVE",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113726538",
            "telephone_number": "718-476-1458",
            "fax_number": "718-476-1462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ-GOMEZ",
        "first_name": "CONSUELO",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2013-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "VUT006194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLOCK",
            "identifier": "922825",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "NY6871",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02042368",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "3101581",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "METROPLUS",
            "identifier": "T006194",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS",
            "identifier": "52743",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "OV27627",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Jackson Heights, NY
• Providers in Jackson Heights, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.