Mauricio Gomez, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2015021625 Issued in MO

Practice address

1319 S Landrum St
Mount Vernon, MO 65712-1910

Phone

(417) 466-2001

Fax

(417) 466-2005

NPI assigned

Jun 25, 2012

Last updated

Dec 17, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO, AR, TX3 enrollments

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 3

Specialty

Family Practice

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cherokee NationGroup PAC ID 5799698742, 446 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vitalcaring Group Home health agency, Tulsa, OK, CCN 377787
• Cherokee Nation W W Hastings Indian Hospital Hospital, Tahlequah, OK, CCN 370171
• Saint Francis Hospital, Inc Hospital, Tulsa, OK, CCN 370091

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mgomezramirez710107@directc.mercy.net
• Direct secure messaging: mgomezramirez710723@directb.mercy.net

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.

• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Sallisaw, OK
  • NPI 1780692723

  TX

  Medicare reassignment Care Compare group NPD
• Mercy Clinic Springfield Communities

  • Family Medicine Physician
  • Springfield, MO
  • NPI 1245277631
  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  dba Mercy Clinic Family Medicine-Willow Springs

  • Rural Health Clinic/Center
  • Willow Springs, MO
  • NPI 1972771657

  Family Medicine

  Medicare reassignment NPD
• Mercy East Ambulatory Services LLC

  dba Mercy-GoHealth Urgent Care

  • Urgent Care Clinic/Center
  • Chesterfield, MO
  • NPI 1134673148
  Medicare reassignment NPD
• Mercy Southern Missouri Ambulatory Services LLC

  • Urgent Care Clinic/Center
  • Springfield, MO
  • NPI 1871094052
  Medicare reassignment NPD
• Mercy Northwest Arkansas Ambulatory Services LLC

  • Urgent Care Clinic/Center
  • Springdale, AR
  • NPI 1366922320
  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  • Family Medicine Physician
  • Hollister, MO
  • NPI 1053350454
  NPD
• Cherokee Nation

  dba Cherokee Nation Public Health

  • Public Health or Welfare Agency
  • Tahlequah, OK
  • NPI 1013884154
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Claremore, OK
  • NPI 1497568968
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Muskogee, OK
  • NPI 1841207156
  NPD

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

• Cherokee Nation

  • General Acute Care Hospital
  • Tahlequah, OK
  • NPI 1275799645
  Care Compare affiliation
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Claremore, OK
  • NPI 1497568968

  Hospital

  Care Compare affiliation
• Saint Francis Hospital, Inc.

  • Rehabilitation Hospital Unit
  • Tulsa, OK
  • NPI 1003039488
  Care Compare affiliation
• Saint Francis Hospital, Inc.

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1144228487
  Care Compare affiliation
• VCG Oklahoma LLC

  dba VitalCaring Group

  • Home Health Agency
  • Tulsa, OK
  • NPI 1073212387
  Care Compare affiliation

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1316201312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505164",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631505164",
            "telephone_number": "417-829-4620",
            "fax_number": "417-829-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 S LANDRUM ST",
            "city": "MOUNT VERNON",
            "state": "MO",
            "postal_code": "657121910",
            "telephone_number": "417-466-2001",
            "fax_number": "417-466-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "MAURICIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-25",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2015021625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316201312",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brooklyn Ruth Fulk, DPT
• Joe A Gardner, MD
• Brian Christopher George, HIS
• John Scott George, BC-HIS
• Glenda Marie Gillaspy, BC-HIS
• Jennifer Nicole Graves, PT, DPT
• Jill Lynette Griesbaum, MS, RD
• Carla Joyce Hall, M.S., L.P.C.
• Kristen Lynne Halsted
• Hearing Crafters of America Inc (Hearing Crafters)

• Family Medicine Physician in Mount Vernon, MO
• Providers in Mount Vernon, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; 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.