Individual provider Active NPI

Hernan Antonio Gomez, M.D.

  • Internal Medicine Physician
  • Kissimmee, FL
National Provider Identifier
1083628192
Registry record updated Nov 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME94311 Issued in FL
Practice address
339 Cypress Pkwy Ste 100
Kissimmee, FL 34759-3315
Phone
(407) 343-3333
Fax
(407) 343-8888
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME94311 FL Primary

Addresses

Primary practice location

339 Cypress Pkwy Ste 100
Kissimmee, FL 34759-3315

Mailing address

339 Cypress Pkwy Ste 100
Kissimmee, FL 34759-3315
Phone (727) 407-3433

Other identifiers 1

IdentifierTypeStateIssuer
276146700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20061004000543 FL Practitioner - Internal Medicine 0840296463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optumcare Florida, LLCGroup PAC ID 3072403476, 266 clinicians

Practice addresses (Care Compare)

339 Cypress Pkwy
Suite 100
Kissimmee, FL 34759-3315
Phone (407) 343-3333

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optumcare Florida, LLC CurrentSince Aug 5, 2019 Accepting new patients
Optumcare Florida LLC Internal Medicine CurrentSince Aug 5, 2019 Accepting new patients
Optumcare Florida Ci, LLC Past Accepting new patients

Locations

1989 W Lumsden Rd
Brandon, FL 33511
Phone (813) 653-3111

1345 West Bay Dr
Ste 202
Largo, FL 33770
Phone (727) 559-0895

339 Cypress Pkwy
Ste 100
Poinciana, FL 34759
Phone (407) 343-3333

10051 5th St N
Ste 200
St Petersburg, FL 33702
Phone (727) 286-4093

5130 Sunforest Dr
Ste 300
Tampa, FL 33634
Phone (813) 302-5835

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: hernan.gomez@wellmed.eclinicaldirectplus.com

Organizations & group practices 3

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 7

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637020800000",
    "number": "1083628192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 CYPRESS PKWY STE 100",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347593315",
            "telephone_number": "727-407-3433",
            "fax_number": "407-343-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 CYPRESS PKWY STE 100",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347593315",
            "telephone_number": "407-343-3333",
            "fax_number": "407-343-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "HERNAN",
        "middle_name": "ANTONIO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME94311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276146700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.