Active NPI
Yassara V Gomes, RN
- Ambulatory Care Registered Nurse
- Brockton, MA
National Provider Identifier
1114650546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Registered Nurse
- License
- 2308343
- Practice address
- 121 Algonquin St
Brockton, MA 02302-2452 - Phone
- (401) 215-8402
- NPI assigned
- Jul 4, 2022
- 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 |
|---|---|---|---|---|
| Ambulatory Care Registered Nurse | 163WP2201X | 2308343 | MA | Primary |
Addresses
Primary practice location
121 Algonquin St
Brockton, MA 02302-2452
Mailing address
121 Algonquin St
Brockton, MA 02302-2452
Phone (401) 215-8402
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 |
|---|---|---|---|
| 2308343 | MA | MD | Ambulatory Care Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656892800000",
"number": "1114650546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 ALGONQUIN ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023022452",
"telephone_number": "401-215-8402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 ALGONQUIN ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023022452",
"telephone_number": "401-215-8402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMES",
"first_name": "YASSARA",
"middle_name": "V",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-04",
"last_updated": "2022-07-04",
"certification_date": "2022-07-04",
"status": "A"
},
"taxonomies": [
{
"code": "163WP2201X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Registered Nurse, Ambulatory Care",
"state": "MA",
"license": "2308343",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.