NPIMap

Individual provider Active NPI

Pablo Gomery, MD

  • Urology Physician
  • Boston, MA
National Provider Identifier
1477527109
Registry record updated May 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
38936 Issued in MA
Practice address
55 Fruit St
GRB 1102 Department of Urology
Boston, MA 02114-2696
Phone
(617) 726-8482
Fax
(617) 726-6131
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 38936 MA Primary

Addresses

Primary practice location

55 Fruit St
GRB 1102 Department of Urology
Boston, MA 02114-2696

Mailing address

PO Box 9142
Mass General Physician Organization
Charlestown, MA 02129-9142
Phone (617) 726-8482

Other identifiers 3

IdentifierTypeStateIssuer
E05279OtherMABCBS MA
2098199MedicaidMA
718390OtherMATUFTS HEALTH PLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040706000374 MA Practitioner - Urology 9739166042 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Albert Einstein College of Medicine of Yeshiva University, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Massachusetts General Physicians Organization IncGroup PAC ID 2466365820, 3,494 clinicians

Practice addresses (Care Compare)

102 Endicott St
MGH North Shore Medical
Danvers, MA 01923-3623
Phone (978) 882-6100

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

  • Mass General Brigham Home Care, Inc Home health agency, Newton, MA, CCN 227207
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035
  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110
  • Wentworth-Douglass Hospital Hospital, Dover, NH, CCN 300018
  • Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38936MAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince May 1, 1980 Accepting new patients
General Hospital Corp Current Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Nov 4, 2002 Accepting new patients

Locations

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

55 Fruit St
#1102
Boston, MA 02114
Phone (617) 726-3010

55 Fruit St
Boston, MA 02114

Interoperability endpoints

  • Direct secure messaging: gomery.pablo.mgh@direct.partners.masshiway.net

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 7

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400630400000",
    "number": "1477527109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9142",
            "address_2": "MASS GENERAL PHYSICIAN ORGANIZATION",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021299142",
            "telephone_number": "617-726-8482",
            "fax_number": "617-726-6131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "GRB 1102 DEPARTMENT OF UROLOGY",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696",
            "telephone_number": "617-726-8482",
            "fax_number": "617-726-6131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMERY",
        "first_name": "PABLO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2014-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MA",
            "license": "38936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "E05279",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2098199",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "718390",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.