Individual provider Active NPI

Edy Kaleimomi Gomes, MD

  • Family Medicine Physician
  • Waimanalo, HI
National Provider Identifier
1336717537
Registry record updated Jun 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MDR-8069 Issued in HI
Practice address
41-1295 Kalanianaole Hwy
Waimanalo, HI 96795-1536
Phone
(808) 259-7948
NPI assigned
Jun 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MDR-8069 HI Primary

Addresses

Primary practice location

41-1295 Kalanianaole Hwy
Waimanalo, HI 96795-1536

Mailing address

41-1295 Kalanianaole Hwy
Waimanalo, HI 96795-1536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20240904002695 HI Practitioner - Family Practice 1658811799 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Hawaii John a. Burns School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Waimanalo Health CenterGroup PAC ID 8527029198, 27 clinicians

Practice addresses (Care Compare)

41 1347 Kalanianaole
Waimanalo, HI 96795-1247

41-1347 Kalanianaole Hwy
Waimanalo, HI 96795-1247
Phone (808) 259-7948

Hospital & facility affiliations

  • Adventist Health Home Care Services Home health agency, Kaneohe, HI, CCN 127017
  • Adventist Health Castle Hospital, Kailua, HI, CCN 120006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MDR-8069HIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Waimanalo Health Center CurrentSince Aug 26, 2024 Accepting new patients

Locations

41-1330 Kalanianaole Hwy
Waimanalo, HI 96795
Phone (808) 259-0460

41-1295 Kalanianaole Hwy
Waimanalo, HI 96795
Phone (808) 259-7948

41-1347 Kalanianaole Hwy
Waimanalo, HI 96795
Phone (808) 259-5466

Interoperability endpoints

  • Direct secure messaging: edy.gomes.p1@direct.waimanalohealth.nextgenshare.com

Organizations & group practices 1

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 2

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": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719705600000",
    "number": "1336717537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41-1295 KALANIANAOLE HWY",
            "city": "WAIMANALO",
            "state": "HI",
            "postal_code": "967951536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41-1295 KALANIANAOLE HWY",
            "city": "WAIMANALO",
            "state": "HI",
            "postal_code": "967951536",
            "telephone_number": "808-259-7948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMES",
        "first_name": "EDY",
        "middle_name": "KALEIMOMI",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-14",
        "last_updated": "2024-06-30",
        "certification_date": "2024-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "MDR-8069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waimanalo, HI

Sources for this page

Verify at the official NPI Registry.