Individual provider Active NPI

Kristina Gomes, PA-C

  • Physician Assistant
  • Sarasota, FL
National Provider Identifier
1205207990
Registry record updated Oct 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9109134 Issued in FL
Practice address
4024 Crockers Lake Blvd Apt 612
Sarasota, FL 34238-5525
Phone
(941) 549-3988
NPI assigned
Oct 7, 2015
Last updated
Oct 7, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9109134 FL Primary

Addresses

Primary practice location

4024 Crockers Lake Blvd Apt 612
Sarasota, FL 34238-5525

Mailing address

4024 Crockers Lake Blvd
Sarasota, FL 34238-5597

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160223000341 FL Practitioner - Physician Assistant 6901101369 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ortho Florida LLCGroup PAC ID 3274616453, 121 clinicians

Practice addresses (Care Compare)

1110 Gulf Breeze Pkwy
Gulf Breeze, FL 32561-4884
Phone (850) 934-2000

1601 Clint Moore Rd
Suite 125
Boca Raton, FL 33487-5714
Phone (561) 939-0800

2600 Laurel Rd E
Nokomis, FL 34275-3226
Phone (941) 261-9000

5741 Bee Ridge Rd
Sarasota, FL 34233-5064
Phone (941) 342-1303

5741 Bee Ridge Rd
Suite 450
Sarasota, FL 34233-5081
Phone (941) 951-2663

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sarasota Orthopedic Associates LLC CurrentSince Sep 28, 2015 Accepting new patients
Ortho Florida, LLC CurrentSince Jun 1, 2022 Accepting new patients
Ortho Florida, LLC CurrentSince Jun 1, 2022 Accepting new patients

Locations

433 Plaza Real
Ste 275
Boca Raton, FL 33432
Phone (561) 262-0084

660 Glades Rd
Ste 460
Boca Raton, FL 33431
Phone (561) 300-1792

1110 Gulf Breeze Pkwy
Pensacola Beach, FL 32561
Phone (850) 438-1848

2750 Bahia Vista St
Ste 100
Sarasota, FL 34239

5741 Bee Ridge Rd
Ste 450
Sarasota, FL 34233
Phone (941) 214-2864

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: kgomes@360-ortho.emadirect.md

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1444176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444176000000",
    "number": "1205207990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4024 CROCKERS LAKE BLVD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342385597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4024 CROCKERS LAKE BLVD APT 612",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342385525",
            "telephone_number": "941-549-3988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMES",
        "first_name": "KRISTINA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-07",
        "last_updated": "2015-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.