Individual provider Active NPI

David Brent Gomez, O.D.

  • Optometrist
  • Beckley, WV
National Provider Identifier
1174512453
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
926OD Issued in WV
Practice address
1623 Robert C. Byrd Dr
Beckley, WV 25801-8747
Phone
(304) 256-3937
Fax
(304) 256-6574
NPI assigned
Oct 19, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 926OD WV Primary

Addresses

Primary practice location

1623 Robert C. Byrd Dr
Beckley, WV 25801-8747

Mailing address

1623 Robert C. Byrd Dr.
Beckley, WV 25801
Phone (304) 256-3937

Other identifiers 1

IdentifierTypeStateIssuer
0149804000MedicaidWV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071003000565 WV Practitioner - Optometry 1456363845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1623 Robert C Byrd Dr
Beckley, WV 25801-8747
Phone (304) 256-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
926ODWVMDOptometrist

Organizations & group practices 1

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": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470700800000",
    "number": "1174512453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1623 ROBERT C. BYRD DR.",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "25801",
            "telephone_number": "304-256-3937",
            "fax_number": "304-256-6574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1623 ROBERT C. BYRD DR",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258018747",
            "telephone_number": "304-256-3937",
            "fax_number": "304-256-6574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "DAVID",
        "middle_name": "BRENT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2016-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WV",
            "license": "926OD",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0149804000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beckley, WV

Sources for this page

Verify at the official NPI Registry.