Individual provider Active NPI

Monica Renee Gomez, NP-C

  • Family Nurse Practitioner
  • Michigan City, IN
National Provider Identifier
1447822697
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F03210844 Issued in IN
Practice address
200 Alfred St
Michigan City, IN 46360
Phone
(219) 872-6200
Fax
(219) 879-2915
NPI assigned
Jul 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F03210844 IN Primary

Addresses

Primary practice location

200 Alfred St
Michigan City, IN 46360

Mailing address

710 Franklin St Ste 200
Michigan City, IN 46360-3564
Phone (219) 872-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210901002080 IN Practitioner - Nurse Practitioner 2860898715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthlinc IncGroup PAC ID 7618929373, 83 clinicians
Chesterton Physical Therapy IncGroup PAC ID 3173683984, 191 clinicians

Practice addresses (Care Compare)

1001 Sturdy Rd
Valparaiso, IN 46383-4126
Phone 21946271732226

425 Sand Creek Dr
Suite C
Chesterton, IN 46304-1589

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
F03210844INMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthlinc, Inc CurrentSince Aug 16, 2021 Accepting new patients
Healthlinc, Inc. CurrentSince Aug 16, 2021 Accepting new patients

Locations

1313 W Chicago Ave
East Chicago, IN 46312
Phone (219) 397-1196

104 E Culver Rd
Ste 106
Knox, IN 46534
Phone (574) 772-7400

710 Franklin St
Ste 200
Michigan City, IN 46360
Phone (219) 872-6200

200 Alfred St
Michigan City, IN 46360
Phone (219) 224-2626

420 W 4th St
Mishawaka, IN 46544
Phone (574) 252-0300

621 Memorial Dr
Ste 402
South Bend, IN 46601
Phone (574) 232-4800

1960 Northside Blvd
South Bend, IN 46615
Phone (574) 231-7228

1708 High St
South Bend, IN 46613
Phone (574) 237-6640

2401 Valley Dr
Valparaiso, IN 46383
Phone (219) 413-5100

1001 Sturdy Rd
Valparaiso, IN 46383
Phone (219) 462-7173

701 Wall St
Valparaiso, IN 46383
Phone (219) 299-8419

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 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": "1626307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1447822697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 FRANKLIN ST STE 200",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463603564",
            "telephone_number": "219-872-6200",
            "fax_number": "219-879-2915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ALFRED ST",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "46360",
            "telephone_number": "219-872-6200",
            "fax_number": "219-879-2915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "MONICA",
        "middle_name": "RENEE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-15",
        "last_updated": "2024-05-16",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "F03210844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Michigan City, IN

Sources for this page

Verify at the official NPI Registry.