Individual provider Active NPI

Joel Gomez, MD

  • Anesthesiology Physician
  • Wellington, FL
National Provider Identifier
1427079813
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
61547 Issued in FL
Practice address
12230 W Forest Hill Blvd
Ste 182
Wellington, FL 33414-5700
Phone
(561) 798-4221
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 61547 FL Primary

Addresses

Primary practice location

12230 W Forest Hill Blvd
Ste 182
Wellington, FL 33414-5700

Mailing address

804 Scott Nixon Memorial Dr
Augusta, GA 30907-2464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170620002003 VA Practitioner - Anesthesiology 2466648126 Reassigns benefits to 2 organizations
I20180817000458 NY Practitioner - Anesthesiology 2466648126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Meharry Medical College School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Anesthesia of New York, P.C.Group PAC ID 7719041102, 50 clinicians

Practice addresses (Care Compare)

207 Foote Ave
Jamestown, NY 14701-7077
Phone (716) 487-0141

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61547FLMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Colleagues Inc Anesthesiology CurrentSince Jan 1, 2018 Accepting new patients
Premier Anesthesia of New York, P.C. Anesthesiology CurrentSince Jul 7, 2018 Accepting new patients
Comprehensive Pain Care of South Florida LLC Past Accepting new patients
Premier Anesthesia of Florida LLC Anesthesiology PastSince Jan 19, 2020 Accepting new patients

Locations

529 Central Ave
Dunkirk, NY 14048
Phone (716) 338-9797

207 Foote Ave
Jamestown, NY 14701
Phone (716) 487-0141

2233 State Route 86
Saranac Lake, NY 12983
Phone (518) 891-4141

200 Medical Park Blvd
Petersburg, VA 23805
Phone (804) 765-5000

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 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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1427079813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SCOTT NIXON MEMORIAL DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309072464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12230 W FOREST HILL BLVD",
            "address_2": "STE 182",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334145700",
            "telephone_number": "561-798-4221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "JOEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "61547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

Verify at the official NPI Registry.