Individual provider Active NPI

Nayra Liseth Gomez-Pena, OCCUPATIONAL THERAPY

  • Occupational Therapist
  • Palm Bay, FL
National Provider Identifier
1407195886
Registry record updated Oct 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0T19153 Issued in FL
Practice address
287 Meehan Ave NW
Palm Bay, FL 32907-2970
Phone
(321) 507-8267
NPI assigned
Feb 5, 2013
Last updated
Oct 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 0T19153 FL Primary

Addresses

Primary practice location

287 Meehan Ave NW
Palm Bay, FL 32907-2970

Mailing address

287 Meehan Ave NW
Palm Bay, FL 32907-2970
Phone (321) 507-8267

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0T19153FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Strength and Balance Institute Occupational Therapist CurrentSince Mar 23, 2021 Accepting new patients
Sobe Innovative Rehabilitation PLLC Occupational Therapist CurrentSince Mar 23, 2021 Accepting new patients
QRM Plus Florida - OT LLC Occupational Therapist CurrentSince Oct 1, 2022 Accepting new patients

Locations

2777 NE 183rd St
Aventura, FL 33160
Phone (305) 405-2014

670 Flushing Ave
Ste 307
Brooklyn, NY 11206

5057 Keller Springs Rd
Ste 150
Addison, TX 75001
Phone (800) 420-1036

Organizations & group practices 3

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": "1360022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1407195886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "287 MEEHAN AVE NW",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329072970",
            "telephone_number": "321-507-8267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "287 MEEHAN AVE NW",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329072970",
            "telephone_number": "321-507-8267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ-PENA",
        "first_name": "NAYRA",
        "middle_name": "LISETH",
        "name_prefix": "Ms.",
        "credential": "OCCUPATIONAL THERAPY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-05",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "0T19153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.