Individual provider Active NPI

Nicole Gabrielle Gomez, MD, MPH

  • Maternal & Fetal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1548716020
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
A136960 Issued in CA
Practice address
1520 San Pablo St
Los Angeles, CA 90033-5310
Phone
(323) 442-5100
NPI assigned
Aug 25, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A136960 CA
Maternal & Fetal Medicine Physician 207VM0101X A136960 CA Primary

Addresses

Primary practice location

1520 San Pablo St
Los Angeles, CA 90033-5310

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-5100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nicole.gomez@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20170823001912 CA Practitioner - Obstetrics/Gynecology 1052683257 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A136960CAMDMaternal & Fetal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc Obstetrics & Gynecology CurrentSince Aug 1, 2021 Accepting new patients
Regents of the Univ of Ca CurrentSince Jul 1, 2017 Accepting new patients
Regents of the University of California CurrentSince Jul 22, 2017 Accepting new patients
Regents of the University of California CurrentSince Jul 22, 2017 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Aug 1, 2021 Accepting new patients
Regents of the Univ of Ca Maternal & Fetal Medicine Current Accepting new patients
Regents of the Univ of Ca CurrentSince Jul 1, 2017 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

191 S Buena Vista St
Ste 435
Burbank, CA 91505
Phone (818) 845-5802

1808 Verdugo Blvd
Ste 413
Glendale, CA 91208
Phone (818) 658-5980

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1300 N Vermont Ave
Ste 301
Los Angeles, CA 90027
Phone (323) 361-6070

11550 Indian Hls
Ste 380
Mission Hills, CA 91345
Phone (818) 361-5069

55 S Lake Ave
Fl 9
Pasadena, CA 91101
Phone (818) 212-7541

39 Congress St
Ste 301
Pasadena, CA 91105
Phone (626) 486-0181

2261 Douglas Blvd
Roseville, CA 95661
Phone (916) 783-1044

2521 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-1104

4860 Y St
Ste 2500
Sacramento, CA 95817
Phone (916) 734-6930

Organizations & group practices 10

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": "1472083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1548716020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 SAN PABLO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335310",
            "telephone_number": "323-442-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "NICOLE",
        "middle_name": "GABRIELLE",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-25",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A136960",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "CA",
            "license": "A136960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nicole.gomez@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1520 San Pablo St",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900335310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.