Individual provider Active NPI

Javier H Gomez, LCSW

  • Clinical Social Worker
  • El Paso, TX
National Provider Identifier
1154301810
Registry record updated Jul 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
08834 Issued in TX
Practice address
6455 Hiller
Ste B-3
El Paso, TX 79925
Phone
(915) 881-1300
Fax
(915) 755-1440
NPI assigned
Jan 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2008

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 08834 TX Primary

Addresses

Primary practice location

6455 Hiller
Ste B-3
El Paso, TX 79925

Mailing address

4748 Harcourt
El Paso, TX 79924-3047
Phone (915) 755-1000

Other identifiers 3

IdentifierTypeStateIssuer
84114OtherTRICARE
108248904MedicaidTX
158013OtherTXVALUE OPTIONS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100915000211 TX Practitioner - Clinical Social Worker 0941255160 Practice locations: El Paso, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1817 Wyoming Ave
El Paso, TX 79903-3406
Phone (915) 383-1872

2419 N Piedras St
El Paso, TX 79930-3403

4748 Harcourt Dr
El Paso, TX 79924-3047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Adl Care at Home Inc. Past Accepting new patients
Jggpo Corporation PastSince Jan 24, 2005 Accepting new patients
Adl Care at Home Inc. Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216944000000",
    "number": "1154301810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4748 HARCOURT",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799243047",
            "telephone_number": "915-755-1000",
            "fax_number": "915-755-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6455 HILLER",
            "address_2": "STE B-3",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "79925",
            "telephone_number": "915-881-1300",
            "fax_number": "915-755-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "JAVIER",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2008-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "08834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "84114",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108248904",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "158013",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.