Active NPI
Ydelis Gomez
- Doula
- Philadelphia, PA
National Provider Identifier
1336956960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Doula
- License
- 20814
- Practice address
- 4417 N 6TH St
Philadelphia, PA 19140-2319 - Phone
- (215) 302-3600
- Fax
- (215) 329-2369
- NPI assigned
- Dec 17, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Doula | 374J00000X | 20814 | PA | Primary |
Addresses
Primary practice location
4417 N 6TH St
Philadelphia, PA 19140-2319
Mailing address
4417 N 6TH St
Philadelphia, PA 19140-2319
Phone (215) 302-3600
Other practice location 1
861 E Allegheny Ave
Philadelphia, PA 19134-2401
Phone (215) 302-3600
Other practice location 2
2940 N 5th St
Philadelphia, PA 19133-2801
Phone (215) 302-3600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20814 | PA | MD | Doula |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Esperanza Health Center, Inc. | Past | Accepting new patients |
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.
-
- Federally Qualified Health Center (FQHC)
- Philadelphia, PA
- NPI 1306933346
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1734393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734393600000",
"number": "1336956960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4417 N 6TH ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191402319",
"telephone_number": "215-302-3600",
"fax_number": "215-329-2369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4417 N 6TH ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191402319",
"telephone_number": "215-302-3600",
"fax_number": "215-329-2369"
}
],
"practiceLocations": [
{
"address_1": "861 E Allegheny Ave",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191342401",
"country_code": "US",
"telephone_number": "215-302-3600",
"fax_number": "215-329-2369",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2940 N 5th St",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191332801",
"country_code": "US",
"telephone_number": "215-302-3600",
"fax_number": "215-329-2369",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOMEZ",
"first_name": "YDELIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-12-17",
"last_updated": "2024-12-17",
"certification_date": "2024-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "374J00000X",
"taxonomy_group": "",
"desc": "Doula",
"state": "PA",
"license": "20814",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.