NPIMap

Organization Active NPI

Gomez Yim & Rastogi, M.D., P.a.

Doing business as Havre de Grace Pediatric Center

  • Pediatrics Physician
  • Havre de Grace, MD
National Provider Identifier
1154145290
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
GOMEZ YIM & RASTOGI, M.D., P.A.
Doing business as
Havre de Grace Pediatric Center
Practice address
253 Lewis LN Ste 203
Havre de Grace, MD 21078-3756
Phone
(410) 939-0696
Fax
(410) 939-6210
NPI assigned
Nov 14, 2024
Organization subpart
Yes
Parent organization
BEL AIR PEDIATRIC CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Authorized official

Name
Robert Yim, MDNPI 1497953939
Title
MD/Owner
Phone
(410) 838-9555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary
Pediatric Pulmonology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0214X

Addresses

Primary practice location

253 Lewis LN Ste 203
Havre de Grace, MD 21078-3756

Mailing address

602 S Atwood Rd Ste 104
Bel Air, MD 21014-4198
Phone (410) 838-9555

Other names 1

  • Havre de Grace Pediatric Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Gomez Yim and Rastogi M2 organizations share this tax ID, including this one
Part of
Gomez Yim and Rastogi M

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

253 Lewis Ln
Ste 203
Havre de Grace, MD 21078
Phone (410) 939-0696

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1731542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731542400000",
    "number": "1154145290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 S ATWOOD RD STE 104",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144198",
            "telephone_number": "410-838-9555",
            "fax_number": "410-836-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "253 LEWIS LN STE 203",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210783756",
            "telephone_number": "410-939-0696",
            "fax_number": "410-939-6210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOMEZ YIM & RASTOGI, M.D., P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BEL AIR PEDIATRIC CENTER",
        "enumeration_date": "2024-11-14",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A",
        "authorized_official_last_name": "YIM",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "410-838-9555",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Havre de Grace Pediatric Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Havre de Grace, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.