Individual provider Active NPI

Kerry Norman Gott, M.D.

  • Infectious Disease Physician
  • Pomona, CA
National Provider Identifier
1013955186
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
G65566 Issued in CA
Practice address
255 E Bonita Ave
Pomona, CA 91767-1923
Phone
(909) 596-7733
Fax
(909) 450-0357
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X G65566 CA Primary

Addresses

Primary practice location

255 E Bonita Ave
Pomona, CA 91767-1923

Mailing address

PO Box 9389
Alta Loma, CA 91701-8389
Phone (909) 268-5645

Other identifiers 4

IdentifierTypeStateIssuer
BK903ZOtherMEDICARE NO CAL PTAN
G65566OtherCACA LICENSE #
00C655660MedicaidCA
GR0059670MedicaidCA

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
I20070402000795 CA Practitioner - Infectious DiseasePractitioner - Internal MedicinePractitioner - Other (Physician) 0749282689 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65566CAMDPharmacist
G65566CAMDInfectious Disease Physician

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1013955186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9389",
            "city": "ALTA LOMA",
            "state": "CA",
            "postal_code": "917018389",
            "telephone_number": "909-268-5645",
            "fax_number": "909-450-0357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 E BONITA AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671923",
            "telephone_number": "909-596-7733",
            "fax_number": "909-450-0357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTT",
        "first_name": "KERRY",
        "middle_name": "NORMAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2023-03-07",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "G65566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NO CAL PTAN",
            "identifier": "BK903Z",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA LICENSE #",
            "identifier": "G65566",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C655660",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0059670",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.