Individual provider Active NPI

Vanessa Gomez

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1124545769
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
101173-1 Issued in NY
Practice address
622 W 168TH St
New York, NY 10032-3720
Phone
(646) 831-4685
NPI assigned
Aug 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 101173-1 NY Primary

Addresses

Primary practice location

622 W 168TH St
New York, NY 10032-3720

Mailing address

106 Atlantic Ave Apt 27
Lynbrook, NY 11563-3455
Phone (917) 515-5251

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250227001933 NY Order and Referring Only - Clinical Social Worker 4486174976

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
101173-1NYMDClinical Social Worker

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

NPI Registry JSON

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

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1124545769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 ATLANTIC AVE APT 27",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115633455",
            "telephone_number": "917-515-5251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "646-831-4685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "VANESSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-24",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "101173-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.