NPIMap

Individual provider Active NPI

John Lyle Tron Montero Gomez, M.D.

  • Neurology Physician
  • Portland, OR
National Provider Identifier
1316389273
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD209119 Issued in OR
Practice address
9135 SW Barnes Rd Ste 461
Portland, OR 97225-6643
Phone
(503) 216-1150
NPI assigned
Jul 20, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD209119 OR Primary
Neurology Physician 2084N0400X 312112 LA
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

9135 SW Barnes Rd Ste 461
Portland, OR 97225-6643

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Other practice location 1

648 Crestwood Drive
Covington, LA 70433
Phone (985) 805-2555

Other practice location 2

433 Plaza St Ste 3A
Bogalusa, LA 70427-3729
Phone (985) 730-6970

Other practice location 3

1150 Robert Blvd Ste 220
Slidell, LA 70458-2006
Phone (985) 805-2555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220428001450 OR Practitioner - Neurology 2567705650 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

9135 SW Barnes Rd
Suite 461
Portland, OR 97225-6643
Phone (503) 216-1150

Hospital & facility affiliations

  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004
  • Providence Portland Medical Center Hospital, Portland, OR, CCN 380061
  • Providence Seaside Hospital Hospital, Seaside, OR, CCN 381303
  • Providence Milwaukie Hospital Hospital, Milwaukie, OR, CCN 380082
  • Adventist Health Tillamook Hospital, Tillamook, OR, CCN 381317

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
312112LAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince May 1, 2022 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince May 1, 2022 Accepting new patients
Providence Health & Services - Oregon CurrentSince May 1, 2022 Accepting new patients
Providence Health & Services - Oregon Neurology CurrentSince May 1, 2022 Accepting new patients
Providence Health & Services - Oregon CurrentSince May 1, 2022 Accepting new patients
Providence Health & Services Oregon CurrentSince May 1, 2022 Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients
Neurocovery, LLC PastSince Aug 18, 2019 Accepting new patients

Locations

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

9135 SW Barnes Rd
Ste 461
Portland, OR 97225
Phone (503) 216-1150

Interoperability endpoints

  • Direct secure messaging: jgomez2340317@oc.providencedirect.org

Organizations & group practices 10

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 9

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": "1374278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1316389273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9135 SW BARNES RD STE 461",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256643",
            "telephone_number": "503-216-1150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "648 Crestwood Drive",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "LA",
            "postal_code": "70433",
            "country_code": "US",
            "telephone_number": "985-805-2555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "433 Plaza St Ste 3A",
            "address_purpose": "LOCATION",
            "city": "Bogalusa",
            "state": "LA",
            "postal_code": "704273729",
            "country_code": "US",
            "telephone_number": "985-730-6970",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1150 Robert Blvd Ste 220",
            "address_purpose": "LOCATION",
            "city": "Slidell",
            "state": "LA",
            "postal_code": "704582006",
            "country_code": "US",
            "telephone_number": "985-805-2555",
            "fax_number": "985-400-5303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "JOHN LYLE TRON",
        "middle_name": "MONTERO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-20",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OR",
            "license": "MD209119",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "LA",
            "license": "312112",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.