Active NPI
Ivette G Gomez, RN
- Critical Care Medicine Registered Nurse
- Commack, NY
National Provider Identifier
1023711074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine Registered Nurse
- License
- 617514-01
- Practice address
- 6 Pam Dr
Commack, NY 11725-5214 - Phone
- (631) 559-6795
- NPI assigned
- Mar 27, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | 617514-01 | NY | Primary |
Addresses
Primary practice location
6 Pam Dr
Commack, NY 11725-5214
Mailing address
6 Pam Dr
Commack, NY 11725-5214
Phone (631) 559-6795
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 617514-01 | NY | MD | Critical Care Medicine Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679875200000",
"number": "1023711074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 PAM DR",
"city": "COMMACK",
"state": "NY",
"postal_code": "117255214",
"telephone_number": "631-559-6795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 PAM DR",
"city": "COMMACK",
"state": "NY",
"postal_code": "117255214",
"telephone_number": "631-559-6795"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "IVETTE",
"middle_name": "G",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-27",
"last_updated": "2023-03-27",
"certification_date": "2023-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "NY",
"license": "617514-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Commack, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.