Individual provider Active NPI

Haley Michelle Gomez

  • Women's Health Nurse Practitioner
  • Anchorage, AK
National Provider Identifier
1518613868
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
205734 Issued in AK
Practice address
2741 Debarr Rd Ste C205
Anchorage, AK 99508-2961
Phone
(907) 279-2273
Fax
(907) 258-7705
NPI assigned
Feb 24, 2022
Last updated
Jan 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95123191 CA
Registered Nurse 163W00000X 26NR20461000 NJ
Registered Nurse 163W00000X 179637 AK
Women's Health Nurse Practitioner 363LW0102X 205734 AK Primary

Addresses

Primary practice location

2741 Debarr Rd Ste C205
Anchorage, AK 99508-2961

Mailing address

18829 Mills Bay Dr
Eagle River, AK 99577-8565
Phone (909) 803-7319

Other practice location 1

4001 Lake Otis Pkwy Ste 101
Anchorage, AK 99508-5200
Phone (800) 769-0045

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20240215001866 AK Practitioner - Nurse Practitioner 1052755246 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Womens Care of Alaska PCGroup PAC ID 8921091091, 8 clinicians

Practice addresses (Care Compare)

2741 Debarr Rd
Suite C205
Anchorage, AK 99508-2961
Phone (907) 279-2273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95123191CAMDRegistered Nurse
26NR20461000NJMDRegistered Nurse
205734AKMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Women's Care of Alaska, PC CurrentSince Jan 15, 2024 Accepting new patients

Locations

2741 Debarr Rd
#C205
Anchorage, AK 99508

2741 Debarr Rd
Ste C205
Anchorage, AK 99508
Phone (907) 279-2273

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1645660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1518613868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18829 MILLS BAY DR",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995778565",
            "telephone_number": "909-803-7319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2741 DEBARR RD STE C205",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082961",
            "telephone_number": "907-279-2273",
            "fax_number": "907-258-7705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4001 Lake Otis Pkwy Ste 101",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995085200",
            "country_code": "US",
            "telephone_number": "800-769-0045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "HALEY",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-24",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95123191",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR20461000",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AK",
            "license": "179637",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AK",
            "license": "205734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.