Individual provider Active NPI

Lissette Pryscilla Gomez, M.D.

  • Trauma Surgery Physician
  • Long Beach, CA
National Provider Identifier
1306233937
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
147665 Issued in CA
Practice address
2801 Atlantic Ave
Long Beach, CA 90806-1701
Phone
(562) 933-2000
NPI assigned
Apr 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgical Critical Care Physician 2086S0102X 147665 CA
Trauma Surgery Physician 2086S0127X 147665 CA Primary

Addresses

Primary practice location

2801 Atlantic Ave
Long Beach, CA 90806-1701

Mailing address

500 S Los Robles Ave Apt 217
Pasadena, CA 91101-3258

Other practice location 1

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031
Phone (404) 778-4889

Other practice location 2

400 W Mineral King Ave
Visalia, CA 93291-6237
Phone (210) 464-7054

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220928001758 CA Practitioner - General Surgery 3577966001 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Baylor College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acute Care Surgery Medical Group IncGroup PAC ID 7214006816, 205 clinicians

Practice addresses (Care Compare)

215 W Janss Rd
Thousand Oaks, CA 91360-1847
Phone (805) 497-2727

Hospital & facility affiliations

  • Memorialcare Long Beach Medical Center Hospital, Long Beach, CA, CCN 050485

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
147665CAMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Affiliates of California CurrentSince Jun 1, 2025 Accepting new patients
Acute Care Surgery Medical Group, Inc. Surgical Critical Care CurrentSince Sep 14, 2022 Accepting new patients
Emory Medical Care Foundation Inc Current Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Aug 1, 2021 Accepting new patients
Emory Medical Care Foundation Surgical Critical Care CurrentSince Aug 1, 2021 Accepting new patients
Acute Care Surgery Medical Group, Inc. Surgical Critical Care PastSince Jul 2, 2023 Accepting new patients

Locations

2801 Atlantic Ave
Long Beach, CA 90806
Phone (310) 933-2000

2865 Atlantic Ave
Ste 104
Long Beach, CA 90806
Phone (562) 933-1820

27700 Medical Center Rd
Mission Viejo, CA 92691
Phone (949) 364-7744

4001 J St
Sacramento, CA 95819
Phone (916) 453-4037

150 N Jackson Ave
Ste 100
San Jose, CA 95116
Phone (408) 769-5340

225 N Jackson Ave
San Jose, CA 95116
Phone (408) 347-4051

2190 Lynn Rd
Ste 300
Thousand Oaks, CA 91360
Phone (805) 242-4884

215 W Janss Rd
Thousand Oaks, CA 91360
Phone (805) 379-5435

400 W Mineral King Ave
Visalia, CA 93291
Phone (559) 624-2001

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

Interoperability endpoints

  • Direct secure messaging: lgomez745711@direct.memorialcare.org

Organizations & group practices 6

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 1

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": "1429574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1306233937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S LOS ROBLES AVE APT 217",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911013258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061701",
            "telephone_number": "562-933-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Jesse Hill Jr Dr SE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303033031",
            "country_code": "US",
            "telephone_number": "404-778-4889",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 W Mineral King Ave",
            "address_purpose": "LOCATION",
            "city": "Visalia",
            "state": "CA",
            "postal_code": "932916237",
            "country_code": "US",
            "telephone_number": "210-464-7054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "LISSETTE",
        "middle_name": "PRYSCILLA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-21",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "CA",
            "license": "147665",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "CA",
            "license": "147665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.