Individual provider Active NPI

Antoinette S. Gomes, MD

  • Vascular & Interventional Radiology Physician
  • Los Angeles, CA
National Provider Identifier
1013953835
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
G19745 Issued in CA
Practice address
100 UCLA Medical PLZ Ste 100
Los Angeles, CA 90024-7000
Phone
(310) 481-7545
Fax
(310) 794-9035
NPI assigned
Jun 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G19745 CA
Vascular & Interventional Radiology Physician 2085R0204X G19745 CA Primary

Addresses

Primary practice location

100 UCLA Medical PLZ Ste 100
Los Angeles, CA 90024-7000

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (310) 301-6800

Other practice location 1

1245 16th St Ste 110
Santa Monica, CA 90404-1240
Phone (310) 319-4033

Other practice location 2

2200 N Sepulveda Blvd
Manhattan Beach, CA 90266-2910
Phone (310) 802-0200

Other identifiers 1

IdentifierTypeStateIssuer
00G197450MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20051216000531 CA Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 2365463460 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
Medical College of Pennsylvania, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
UCLA Radiology Medical GroupGroup PAC ID 8921902065, 193 clinicians

Practice addresses (Care Compare)

300 UCLA Medical PLZ
Suite B130
Los Angeles, CA 90095-8346
Phone (310) 206-0456

4343 Lankershim Blvd
North Hollywood, CA 91602-2705

757 Westwood PLZ
Los Angeles, CA 90095-8358
Phone (310) 825-9111

Hospital & facility affiliations

  • Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262
  • Santa Monica - UCLA Med Ctr & Orthopaedic Hospital Hospital, Santa Monica, CA, CCN 050112

Merit-based Incentive Payment System (MIPS)

Final score
81.13 of 100Reported as group
Quality
62.91
Promoting interoperability
100
Improvement activities
40
Cost
68.15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G19745CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Jun 1, 2014 Accepting new patients
Regents of the University of California CurrentSince Jun 1, 2014 Accepting new patients
UCLA Radiology Medical Group Diagnostic Radiology CurrentSince May 1, 2019 Accepting new patients
The Regents of the University of California Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients
UCLA Medical Group Diagnostic Radiology Past Accepting new patients

Locations

26585 Agoura Rd
Ste 210
Calabasas, CA 91302
Phone (818) 878-0028

1000 Flower St
Glendale, CA 91201
Phone (818) 659-5000

100 UCLA Medical Plz
Ste 170
Los Angeles, CA 90024
Phone (858) 534-3880

300 UCLA Medical Plz
Ste B130
Los Angeles, CA 90095
Phone (310) 206-0456

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

757 Westwood Plz
Ste 2125D
Los Angeles, CA 90095

100 UCLA Medical Plz
Ste 100
Los Angeles, CA 90024
Phone (310) 206-8900

File 59755
Los Angeles, CA 90074

2200 N Sepulveda Blvd
Manhattan Beach, CA 90266
Phone (310) 802-0200

4343 Lankershim Blvd
Ste 300
North Hollywood, CA 91602

4343 Lankershim Blvd
#200
North Hollywood, CA 91602
Phone (818) 843-9038

1187 Coast Village Rd
Ste 10B
Santa Barbara, CA 93108
Phone (805) 403-8541

1187 Coast Village Rd
Ste 10A
Santa Barbara, CA 93108
Phone (805) 565-0020

1245 16th St
Ste 105
Santa Monica, CA 90404
Phone (310) 319-3489

1245 16th St
Ste 110
Santa Monica, CA 90404
Phone (310) 319-4033

1250 16th St
Santa Monica, CA 90404
Phone (310) 301-8695

100 Moody Ct
Thousand Oaks, CA 91360
Phone (805) 418-3500

Interoperability endpoints

  • Direct secure messaging: agomes59318@direct.uclahealth.org

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1013953835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 UCLA MEDICAL PLZ STE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900247000",
            "telephone_number": "310-481-7545",
            "fax_number": "310-794-9035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1245 16th St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904041240",
            "country_code": "US",
            "telephone_number": "310-319-4033",
            "fax_number": "310-794-9035",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 N Sepulveda Blvd",
            "address_purpose": "LOCATION",
            "city": "Manhattan Beach",
            "state": "CA",
            "postal_code": "902662910",
            "country_code": "US",
            "telephone_number": "310-802-0200",
            "fax_number": "310-794-9035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOMES",
        "first_name": "ANTOINETTE",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G19745",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "G19745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G197450",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.