NPIMap

Individual provider Active NPI

Jose Enrique Gomez, MD, PHD

  • Critical Care Medicine (Internal Medicine) Physician
  • Duluth, MN
National Provider Identifier
1194748657
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
47415 Issued in MN
Practice address
400 E 3Rd St
McL2Cred
Duluth, MN 55805-1951
Phone
(218) 786-8319
Fax
(218) 722-8792
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 47415 MN
Pulmonary Disease Physician 207RP1001X 47415 MN
Pediatrics Physician 208000000X 47415 MN
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 47415 MN Primary

Addresses

Primary practice location

400 E 3Rd St
McL2Cred
Duluth, MN 55805-1951

Mailing address

Essentia Health Duluth Clinic MSS SSB-5
400 East Third Street
Duluth, MN 55805-1951
Phone (218) 786-3146

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150306001477 MN Practitioner - Critical Care (Intensivists)Practitioner - Pulmonary DiseasePractitioner - Hospitalist 4385867456 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Hospitalist
Education
University of Minnesota Medical School, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Hospital & facility affiliations

  • Essentia Health St Mary'S Medical Center Hospital, Duluth, MN, CCN 240002
  • Range Regional Health Services Hospital, Hibbing, MN, CCN 240040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph'S Medical Center CurrentSince Aug 6, 2020 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
The Duluth Clinic, LTD CurrentSince Aug 17, 2015 Accepting new patients
The Duluth Clinic, LTD. CurrentSince Aug 17, 2015 Accepting new patients
St. Joseph'S Medical Center Current Accepting new patients
St Joseph'S Medical Center CurrentSince Aug 6, 2020 Accepting new patients
St Marys Medical Center Past Accepting new patients

Locations

523 N 3rd St
Brainerd, MN 56401
Phone (218) 828-7394

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

400 E 3rd St
#2
Duluth, MN 55805
Phone (218) 786-8319

Organizations & group practices 7

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1194748657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ESSENTIA HEALTH DULUTH CLINIC MSS SSB-5",
            "address_2": "400 EAST THIRD STREET",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-3146",
            "fax_number": "218-786-7315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "address_2": "MCL2CRED",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8319",
            "fax_number": "218-722-8792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "JOSE",
        "middle_name": "ENRIQUE",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "47415",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MN",
            "license": "47415",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "47415",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MN",
            "license": "47415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.