Active NPI
Robert J. Gomez, M.D.
- Pediatric Critical Care Medicine Physician
- Norfolk, VA
National Provider Identifier
1497707913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Medicine Physician
- License
- 0101040921
- Practice address
- 601 Childrens LN
Norfolk, VA 23507-1910 - Phone
- (757) 668-7331
- Fax
- (757) 668-7537
- NPI assigned
- May 16, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Critical Care Medicine Physician | 2080P0203X | 0101040921 | VA | Primary |
| Pediatrics Physician | 208000000X | 0101040921 | VA | |
| Anesthesiology Physician | 207L00000X | 0101040921 | VA |
Addresses
Primary practice location
601 Childrens LN
Norfolk, VA 23507-1910
Mailing address
PO Box 79137
Baltimore, MD 21279-0137
Phone (757) 668-7200
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0017059860001 | Medicaid | PA | |
| 0180245000 | Medicaid | WV | |
| 1000035014 | Medicaid | DE | |
| 890505J | Medicaid | NC | |
| 006722229 | Medicaid | VA | |
| 122671100 | Medicaid | MD |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101040921 | VA | MD | Pediatric Critical Care Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1260316800000",
"number": "1497707913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 79137",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212790137",
"telephone_number": "757-668-7200",
"fax_number": "757-668-9691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 CHILDRENS LN",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235071910",
"telephone_number": "757-668-7331",
"fax_number": "757-668-7537"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "ROBERT",
"middle_name": "J.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-16",
"last_updated": "2009-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "VA",
"license": "0101040921",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VA",
"license": "0101040921",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "VA",
"license": "0101040921",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0017059860001",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0180245000",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1000035014",
"state": "DE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "890505J",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "006722229",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "122671100",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Norfolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.