Individual provider Active NPI

Erika Gomez, M.D.

  • General Practice Physician
  • Ponce, PR
National Provider Identifier
1497989818
Registry record updated Mar 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
17331 Issued in PR
Practice address
3429 Paseo Versatil
Vista Point
Ponce, PR 00716-4824
Phone
(787) 848-6676
Fax
(787) 260-1441
NPI assigned
May 13, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 17331 PR Primary

Addresses

Primary practice location

3429 Paseo Versatil
Vista Point
Ponce, PR 00716-4824

Mailing address

3429 Paseo Versatil
Vista Point
Ponce, PR 00716-4824
Phone (787) 848-6676

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120119000718 PR Practitioner - General PracticePractitioner - General Surgery 9931376779 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17331PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Medico Central Coto Laurel, Inc CurrentSince May 5, 2019 Accepting new patients
Southern Hospital Services Inc CurrentSince Sep 12, 2011 Accepting new patients
Southern Hospital Service Inc CurrentSince Sep 12, 2011 Accepting new patients

Locations

77 Calle Central
Coto Laurel, PR 00780
Phone (787) 221-2052

6 Calle La Cruz
Juana Diaz, PR 00795
Phone (787) 837-2265

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1242172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520812800000",
    "number": "1497989818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3429 PASEO VERSATIL",
            "address_2": "VISTA POINT",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007164824",
            "telephone_number": "787-848-6676",
            "fax_number": "787-260-1441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3429 PASEO VERSATIL",
            "address_2": "VISTA POINT",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007164824",
            "telephone_number": "787-848-6676",
            "fax_number": "787-260-1441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "ERIKA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-13",
        "last_updated": "2018-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "17331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.