Active NPI
Lisa Estefan Gomez
- Social Worker
- Brooklyn, NY
National Provider Identifier
1437821097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 113299
- Practice address
- 2857 Linden Blvd
Brooklyn, NY 11208-5126 - Phone
- (718) 235-3100
- NPI assigned
- Oct 1, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 113299 | NY | Primary |
Addresses
Primary practice location
2857 Linden Blvd
Brooklyn, NY 11208-5126
Mailing address
2312 54TH St
Fennville, MI 49408-8518
Phone (616) 312-9765
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 113299 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633046400000",
"number": "1437821097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2312 54TH ST",
"city": "FENNVILLE",
"state": "MI",
"postal_code": "494088518",
"telephone_number": "616-312-9765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2857 LINDEN BLVD",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112085126",
"telephone_number": "718-235-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "LISA",
"middle_name": "ESTEFAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-01",
"last_updated": "2021-10-01",
"certification_date": "2021-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "113299",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.