Individual provider Active NPI

Joav Gomez, PT, DPT

  • Physical Therapist
  • Loganville, GA
National Provider Identifier
1073356804
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT017152 Issued in GA
Practice address
2735 Loganville Hwy Ste B
Loganville, GA 30052-8615
Phone
(678) 404-7800
Fax
(678) 404-7956
NPI assigned
Jun 18, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT017152 GA Primary

Addresses

Primary practice location

2735 Loganville Hwy Ste B
Loganville, GA 30052-8615

Mailing address

2735 Loganville Hwy Ste B
Loganville, GA 30052-8615
Phone (678) 404-7800

Other practice location 1

705 Breedlove Dr Ste 300
Monroe, GA 30655-2080
Phone (678) 635-7221

Other practice location 2

426 Exchange Blvd Ste 100
Bethlehem, GA 30620-1791
Phone (678) 975-7225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240723003804 GA Practitioner - Physical Therapist in Private Practice 3476099706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of the Incarnate Word School of Osteo Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Compass Physical TherapyGroup PAC ID 7315276714, 7 clinicians

Practice addresses (Care Compare)

2735 Loganville Hwy
Suite B
Loganville, GA 30052-8615
Phone (678) 404-7800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Physical Therapy Physical Therapist CurrentSince Jun 20, 2024 Accepting new patients

Locations

426 Exchange Blvd
Ste 100
Bethlehem, GA 30620
Phone (678) 975-7225

2735 Loganville Hwy
Ste B
Loganville, GA 30052
Phone (678) 404-7800

705 Breedlove Dr
Ste 300
Monroe, GA 30655
Phone (678) 635-7221

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": "1718668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1073356804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2735 LOGANVILLE HWY STE B",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300528615",
            "telephone_number": "678-404-7800",
            "fax_number": "678-404-7956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2735 LOGANVILLE HWY STE B",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300528615",
            "telephone_number": "678-404-7800",
            "fax_number": "678-404-7956"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "705 Breedlove Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "GA",
            "postal_code": "306552080",
            "country_code": "US",
            "telephone_number": "678-635-7221",
            "fax_number": "678-635-7298",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "426 Exchange Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Bethlehem",
            "state": "GA",
            "postal_code": "306201791",
            "country_code": "US",
            "telephone_number": "678-975-7225",
            "fax_number": "678-975-7272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "JOAV",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-18",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT017152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loganville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.