Active NPI
Lissette Pryscilla Gomez, M.D.
- Trauma Surgery Physician
- Long Beach, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Trauma Surgery Physician
- License
- 147665
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
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
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 147665 | CA | MD | Surgical Critical Care Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Surgical Affiliates of California | Current | Accepting new patients | |
| Acute Care Surgery Medical Group, Inc. | Surgical Critical Care | Current | Accepting new patients |
| Emory Medical Care Foundation Inc | Current | Accepting new patients | |
| Emory Medical Care Foundation Inc | Current | Accepting new patients | |
| Emory Medical Care Foundation | Surgical Critical Care | Current | Accepting new patients |
| Acute Care Surgery Medical Group, Inc. | Surgical Critical Care | Past | 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
- 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.
-
- Surgery Physician
- Sacramento, CA
- NPI 1700069549
Surgical Critical Care
-
- Surgery Physician
- Los Banos, CA
- NPI 1932440781
-
- Emergency Medicine Physician
- Atlanta, GA
- NPI 1982860490
Surgical Critical Care
-
- Internal Medicine Physician
- Atlanta, GA
- NPI 1063452381
-
- Diagnostic Radiology Physician
- Atlanta, GA
- NPI 1225294739
-
- Surgery Physician
- Westminster,, CO
- NPI 1477239267
Surgical Critical Care
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Long Beach, CA
- NPI 1962442012
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.