Individual provider Active NPI

Luis Gomez

  • Physical Therapist
  • Sacramento, CA
National Provider Identifier
1134838121
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
303158 Issued in CA
Practice address
9852 Business Park Dr Ste a
Sacramento, CA 95827-1709
Phone
(916) 362-7962
NPI assigned
Nov 17, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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 303158 CA Primary

Addresses

Primary practice location

9852 Business Park Dr Ste a
Sacramento, CA 95827-1709

Mailing address

13045 Jackson Rd
Sloughhouse, CA 95683-9701

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230206001820 CA Practitioner - Physical Therapist in Private Practice 9032581715 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jagdeep Garcha PTGroup PAC ID 8325313471, 5 clinicians

Practice addresses (Care Compare)

8031 Fruitridge Rd
Suite Aandb
Sacramento, CA 95820-6777
Phone (916) 669-9038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
303158CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
MDRS Spine & Sport, Inc Physical Therapist CurrentSince Nov 18, 2022 Accepting new patients
Golden Bear Physical Therapy Sports Injury Center, Inc Physical Therapist CurrentSince Dec 27, 2022 Accepting new patients
Jagdeep Garcha P.T Physical Therapist CurrentSince Apr 18, 2024 Accepting new patients
MDRS Spine & Sport, Inc Physical Therapist CurrentSince Nov 18, 2022 Accepting new patients
Gold Country Therapies, Inc PastSince Jan 1, 2015 Accepting new patients

Locations

450 Rosewood Ave
Ste 105
Camarillo, CA 93010
Phone (805) 389-4781

1020 Tierra del Rey
Ste A1
Chula Vista, CA 91910
Phone (619) 585-7104

14150 Culver Dr
Ste 103
Irvine, CA 92604
Phone (949) 262-9142

1335 Coffee Rd
Ste 200
Modesto, CA 95355
Phone (209) 576-1946

1700 Keystone Pacific Pkwy
Unit C2
Patterson, CA 95363
Phone (209) 881-9274

1222 W Colony Rd
Ste 130
Ripon, CA 95366
Phone (209) 624-1288

9852 Business Park Dr
Ste A
Sacramento, CA 95827
Phone (916) 362-7962

8031 Fruitridge Rd
Ste Ab
Sacramento, CA 95820
Phone 9166699038 ext. 1010

3760 Convoy St
Ste 101
San Diego, CA 92111
Phone (858) 264-1434

1801 Cleveland Ave
Ste B
Santa Rosa, CA 95401
Phone (707) 526-4180

1906 Vista del Lago Dr
Ste A
Valley Springs, CA 95252
Phone (209) 772-0848

Organizations & group practices 5

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": "1668643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1134838121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13045 JACKSON RD",
            "city": "SLOUGHHOUSE",
            "state": "CA",
            "postal_code": "956839701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9852 BUSINESS PARK DR STE A",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958271709",
            "telephone_number": "916-362-7962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "LUIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-17",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "303158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; 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.