Active NPI
Alice Ballesteros Gomez, O.D.
- Ophthalmology Physician
- Elmhurst, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- TUV006724
- Practice address
- 7901 Broadway
Room A1-9
Elmhurst, NY 11373-1329 - Phone
- (718) 334-4952
- Fax
- (718) 334-4815
- NPI assigned
- Sep 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | TUV006724 | NY | Primary |
Addresses
Primary practice location
7901 Broadway
Room A1-9
Elmhurst, NY 11373-1329
Mailing address
7901 Broadway
Room A1-9
Elmhurst, NY 11373-1329
Phone (718) 334-4952
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- State University of New York - State College Optometry, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
234 E 149 St
Bronx, NY 10451-5504
Phone (718) 579-6101
2601 Ocean Pkwy
Brooklyn, NY 11235-7745
Phone (718) 616-5356
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TUV006724 | NY | MD | Ophthalmology Physician |
| 006724 | NY | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physician Affiliate Group of New York PC | Current | Accepting new patients | |
| Downtown Bronx Medical Associates PC | Current | Accepting new patients |
Locations
234 Eugenio Maria de Hosto Blvd
Bronx, NY 10451
Phone (718) 579-5874
2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354
506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000
Interoperability endpoints
- agomezballesteros10664@nychhc.direct-ci.com
Organizations & group practices 2
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.
-
- Registered Dietitian
- New York, NY
- NPI 1013375526
-
- Emergency Medical Services (Emergency Medicine) Physician
- Bronx, NY
- NPI 1689618407
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bronx, NY
- NPI 1427063270
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268092800000",
"number": "1578662136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7901 BROADWAY",
"address_2": "ROOM A1-9",
"city": "ELMHURST",
"state": "NY",
"postal_code": "113731329",
"telephone_number": "718-334-4952",
"fax_number": "718-334-4815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7901 BROADWAY",
"address_2": "ROOM A1-9",
"city": "ELMHURST",
"state": "NY",
"postal_code": "113731329",
"telephone_number": "718-334-4952",
"fax_number": "718-334-4815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALLESTEROS GOMEZ",
"first_name": "ALICE",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-21",
"last_updated": "2010-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "NY",
"license": "TUV006724",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Elmhurst, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2010; 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.