Jacqueline Gomez, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

212251 Issued in NC

Practice address

729 N Medical Center Dr W Ste 223
Clovis, CA 93611-6885

Phone

(559) 449-9990

NPI assigned

Nov 19, 2015

Last updated

Mar 20, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Physician Assistant

Education

George Washington University School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shamsuddin Khwaja M D IncGroup PAC ID 5799810784, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Regional Medical Center Hospital, Fresno, CA, CCN 050060
• Clovis Community Medical Center Hospital, Clovis, CA, CCN 050492

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Shamsuddin Khwaja M D Inc

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Clovis, CA
  • NPI 1699006650
  Medicare reassignment Care Compare group
• Community Foundation Medical Group

  dba Sante' Foundation Medical Group

  • Internal Medicine Physician
  • Fresno, CA
  • NPI 1811258510
  Medicare reassignment NPD (past)
• Community Foundation Medical Group

  dba Sante' Foundation Medical Group

  • Orthopaedic Surgery Physician
  • Fresno, CA
  • NPI 1376056721
  NPD
• Fresno Community Hospital and Medical Center

  dba Community Regional Medical Center

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1104906569
  NPD (past)

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

• Fresno Community Hospital and Medical Center

  dba Community Regional Medical Center

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1104906569
  Care Compare affiliation
• Fresno Community Hospital and Medical Center

  dba Clovis Community Medical Center

  • General Acute Care Hospital
  • Clovis, CA
  • NPI 1316027709
  Care Compare affiliation

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

{
    "created_epoch": "1447891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1235503814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 N MEDICAL CENTER DR W STE 223",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 N MEDICAL CENTER DR W STE 223",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116885",
            "telephone_number": "559-449-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "JACQUELINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-19",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "212251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Golden Bird Home Health Care, Inc
• Golden Valley Smiles
• Golden Valley Smiles
• Brontae Noel Gomes
• Brianna Nicole Gomez, MA
• Litzy Sherlyn Gomez
• Mark Anthony Gomez
• Rebecca R Gomez, LMFT, M.S.
• Nischint Gondara, MD
• Sherri Elizabeth Gong-Chun, RPH, PHARMD

• Surgical Physician Assistant in Clovis, CA
• Providers in Clovis, CA by specialty
• Surgical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.