Individual provider Active NPI

James J Gomez, MD

  • Obstetrics & Gynecology Physician
  • Melrose Park, IL
National Provider Identifier
1376654103
Registry record updated May 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036084959 Issued in IL
Practice address
8321 W North Ave
Melrose Park, IL 60160-1605
Phone
(708) 681-2298
Fax
(708) 681-2398
NPI assigned
Aug 31, 2006
Last updated
May 13, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036084959 IL Primary

Addresses

Primary practice location

8321 W North Ave
Melrose Park, IL 60160-1605

Mailing address

8321 W North Ave
Melrose Park, IL 60160-1605
Phone (708) 681-2298

Other identifiers 1

IdentifierTypeStateIssuer
036084959MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20040313000397 IL Practitioner - Obstetrics/Gynecology 9739078064 Reassigns benefits to 1 organization
Receives reassigned benefits from 6 practitioners
Practice locations: Melrose Park, IL

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

675 W N Ave
Suite 505
Melrose Park, IL 60160-1626
Phone (708) 450-5762

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036084959ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Access Community Health Network CurrentSince Mar 14, 2011 Accepting new patients
Access Community Health Network CurrentSince Mar 14, 2011 Accepting new patients
Access Community Health Network Current Accepting new patients
Lloyd W Klein MD SC Past Accepting new patients
A-1 Medical Imaging Past Accepting new patients

Locations

8321 W North Ave
Melrose Park, IL 60160
Phone (708) 343-8800

Interoperability endpoints

  • Direct secure messaging: james.gomez.1@11754.direct.athenahealth.com

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336867200000",
    "number": "1376654103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8321 W NORTH AVE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601605",
            "telephone_number": "708-681-2298",
            "fax_number": "708-681-2398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8321 W NORTH AVE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601605",
            "telephone_number": "708-681-2298",
            "fax_number": "708-681-2398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "JAMES",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2012-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036084959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036084959",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose Park, IL

Sources for this page

Verify at the official NPI Registry.