NPIMap

Organization Active NPI

Gomez Yim & Rastogi, M.D., P.a.

  • Pediatrics Physician
  • Bel Air, MD
National Provider Identifier
1407980717
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
GOMEZ YIM & RASTOGI, M.D., P.A.
Practice address
602 S Atwood Rd Ste 104
Bel Air, MD 21014-4198
Phone
(410) 838-9555
Fax
(410) 836-5056
NPI assigned
Mar 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Authorized official

Name
Robert Phillip Yim I, M.D.NPI 1497953939
Title
Owner
Phone
(410) 838-9555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

602 S Atwood Rd Ste 104
Bel Air, MD 21014-4198

Mailing address

602 S. Atwood Road
Suite 104
Bel Air, MD 21014
Phone (410) 838-9555

Other practice location 1

253 Lewis Ln Ste 203
Havre DE Grace, MD 21078-3756
Phone (410) 939-0696

Other identifiers 1

IdentifierTypeStateIssuer
226381500MedicaidMD

Other names 1

  • Bel Air Pediatric Center Havre de Grace Pediatric Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Gomez Yim and Rastogi M2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

602 S Atwood Rd
Ste 104
Bel Air, MD 21014
Phone (410) 638-1611

615 W Macphail Rd
Ste 107
Bel Air, MD 21014
Phone (410) 838-9555

253 Lewis Ln
Ste 203
Havre de Grace, MD 21078
Phone (410) 939-0696

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731369600000",
    "number": "1407980717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 S. ATWOOD ROAD",
            "address_2": "SUITE 104",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "21014",
            "telephone_number": "410-838-9555",
            "fax_number": "410-836-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 S ATWOOD RD STE 104",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144198",
            "telephone_number": "410-838-9555",
            "fax_number": "410-836-5056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "253 Lewis Ln Ste 203",
            "address_purpose": "LOCATION",
            "city": "Havre DE Grace",
            "state": "MD",
            "postal_code": "210783756",
            "country_code": "US",
            "telephone_number": "410-939-0696",
            "fax_number": "410-939-6210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GOMEZ YIM & RASTOGI, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A",
        "authorized_official_last_name": "YIM",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "PHILLIP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-838-9555",
        "authorized_official_name_suffix": "I",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "226381500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bel Air Pediatric Center Havre de Grace Pediatric Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bel Air, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.

Verify at the official NPI Registry.