Active NPI
Herbert Gomberg, M.D.
- Psychiatry Physician
- Dallas, TX
National Provider Identifier
1205173085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- F4845
- Practice address
- 5924 Royal LN
Suite 260
Dallas, TX 75230-3863 - Phone
- (214) 691-8606
- Fax
- (972) 233-9022
- NPI assigned
- Jan 13, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | F4845 | TX | Primary |
Addresses
Primary practice location
5924 Royal LN
Suite 260
Dallas, TX 75230-3863
Mailing address
5924 Royal LN
Suite 260
Dallas, TX 75230-3863
Phone (214) 691-8606
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2017 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F4845 | TX | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358035200000",
"number": "1205173085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5924 ROYAL LN",
"address_2": "SUITE 260",
"city": "DALLAS",
"state": "TX",
"postal_code": "752303863",
"telephone_number": "214-691-8606",
"fax_number": "972-233-9022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5924 ROYAL LN",
"address_2": "SUITE 260",
"city": "DALLAS",
"state": "TX",
"postal_code": "752303863",
"telephone_number": "214-691-8606",
"fax_number": "972-233-9022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMBERG",
"first_name": "HERBERT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-01-13",
"last_updated": "2013-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TX",
"license": "F4845",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.