Active NPI
Carolina Gomez-Angulo, OD
- Optometrist
- Roxbury, MA
National Provider Identifier
1255011649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5639
- Practice address
- 45 Dimock St
Roxbury, MA 02119-1208 - Phone
- (617) 442-8800
- Fax
- (617) 427-4566
- NPI assigned
- Jul 20, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 5639 | MA | Primary |
Addresses
Primary practice location
45 Dimock St
Roxbury, MA 02119-1208
Mailing address
55 Dimock St
Roxbury, MA 02119-1029
Phone (617) 442-4088
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: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5639 | MA | MD | Optometrist |
Interoperability endpoints
- cgomezangulo719512@direct.ochin.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692316800000",
"number": "1255011649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 DIMOCK ST",
"city": "ROXBURY",
"state": "MA",
"postal_code": "021191029",
"telephone_number": "617-442-4088",
"fax_number": "617-442-4088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 DIMOCK ST",
"city": "ROXBURY",
"state": "MA",
"postal_code": "021191208",
"telephone_number": "617-442-8800",
"fax_number": "617-427-4566"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ-ANGULO",
"first_name": "CAROLINA",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-20",
"last_updated": "2023-08-18",
"certification_date": "2023-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MA",
"license": "5639",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roxbury, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.