Active NPI
Luis Alfonso Gomez Jr., LMSW
- Social Worker
- Bronx, NY
National Provider Identifier
1487931408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 084983-1
- Practice address
- 3600 Jerome Ave
Fegs Bronx Pros
Bronx, NY 10467-1052 - Phone
- (718) 881-7600
- Fax
- (718) 654-1465
- NPI assigned
- Nov 4, 2011
- Sex
- Male
- Sole proprietor
- No
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 | 084983-1 | NY | Primary |
Addresses
Primary practice location
3600 Jerome Ave
Fegs Bronx Pros
Bronx, NY 10467-1052
Mailing address
53 Vermilyea Ave
4D
New York, NY 10034-4443
Phone (646) 626-2545
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 084983-1 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398297600000",
"number": "1487931408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "53 VERMILYEA AVE",
"address_2": "4D",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100344443",
"telephone_number": "646-626-2545"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 JEROME AVE",
"address_2": "FEGS BRONX PROS",
"city": "BRONX",
"state": "NY",
"postal_code": "104671052",
"telephone_number": "718-881-7600",
"fax_number": "718-654-1465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "LUIS",
"middle_name": "ALFONSO",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-11-04",
"last_updated": "2014-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "084983-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.