Clive Gomilla, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1031969 Issued in TX

Practice address

18980 W Memorial Dr
#100
Humble, TX 77338

Phone

(832) 644-8930

NPI assigned

Mar 14, 2021

Last updated

Aug 25, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

University of Texas Medical Branch at Galveston, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Houston Cardiovascular Assoc PAGroup PAC ID 7911992151, 82 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: clive.gomilla@ushv.eclinicaldirectplus.com

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.

• Houston Cardiovascular Assoc PA

  • Cardiovascular Disease Physician
  • Houston, TX
  • NPI 1487746020

  Family

  Medicare reassignment Care Compare group NPD
• Rajiv Agarwal MD PA

  dba Modern Rehabilitation Center

  • Cardiac Rehabilitation Clinic/Center
  • Humble, TX
  • NPI 1598407017
  Medicare reassignment
• Houston Cardiovascular Assoc PA

  • Cardiac Rehabilitation Registered Nurse
  • Houston, TX
  • NPI 1831993369
  NPD

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

{
    "created_epoch": "1615680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1568047249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2123 ENDICOTT LN",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774786027",
            "telephone_number": "832-875-5762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18980 W MEMORIAL DR",
            "address_2": "#100",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "77338",
            "telephone_number": "832-644-8930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMILLA",
        "first_name": "CLIVE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-14",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1031969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan C Godson, PT, OCS
• Tiara Golden
• Douglas Rudolph Goldstein, D.C.
• Chloe Goltl
• Karen Liseth Gomez
• Ayrielle Gonzalez
• Celsio Gonzalez, MD
• Jazmin De Abril Gonzalez
• Juan Manuel Gonzalez Jr., DDS
• Nino Alissandro Gonzalez, RDN

• Family Nurse Practitioner in Humble, TX
• Providers in Humble, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.