Individual provider Active NPI

Jessica Ann Gomez, N.P

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1174033799
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP134510 Issued in TX
Practice address
5206 Research Dr
San Antonio, TX 78240-5251
Phone
(210) 595-5300
Fax
(210) 595-5301
NPI assigned
Oct 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP134510 TX Primary

Addresses

Primary practice location

5206 Research Dr
San Antonio, TX 78240-5251

Mailing address

PO Box 911230
Dallas, TX 75391-1230
Phone (972) 997-8000

Other identifiers 1

IdentifierTypeStateIssuer
378736802MedicaidTX

Other names 1

  • Jessica Perreau Former name

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171218000565 TX Practitioner - Nurse Practitioner 7214295435 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Oncology PAGroup PAC ID 5395658934, 1,001 clinicians

Practice addresses (Care Compare)

5206 Research Dr
San Antonio, TX 78240-5251
Phone (210) 595-5300

Merit-based Incentive Payment System (MIPS)

Final score
85.12 of 100Reported as apm
Quality
67.48
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP134510TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center El Paso CurrentSince Oct 1, 2017 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Oct 1, 2017 Accepting new patients
Texas Tech University Health Sciences Center El Paso Current Accepting new patients
Texas Oncology PA CurrentSince May 20, 2019 Accepting new patients
Texas Oncology PA CurrentSince May 20, 2019 Accepting new patients

Locations

4801 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5200

1201 E Schuster Ave
Bldg 7
El Paso, TX 79902
Phone (915) 229-6448

7848 Gateway Blvd E
El Paso, TX 79915
Phone (915) 599-1313

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

5206 Research Dr
San Antonio, TX 78240

Interoperability endpoints

  • Direct secure messaging: jessica.perreau@txo.ikm.direct-ci.com

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": "1507593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1174033799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 911230",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753911230",
            "telephone_number": "972-997-8000",
            "fax_number": "972-234-2987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5206 RESEARCH DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782405251",
            "telephone_number": "210-595-5300",
            "fax_number": "210-595-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "credential": "N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-10",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP134510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378736802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "PERREAU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.