Mario San Martin Gomez, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

ME157634 Issued in FL

Practice address

636 Del Prado Blvd S
Cape Coral, FL 33990-2668

Phone

(239) 424-3123

Fax

(239) 424-4041

NPI assigned

Jan 28, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 1

Electronic endpoints 4

Medicare fee-for-service enrollment

Enrolled in MI, WI, FL, NY, VA5 enrollments

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 5

Specialty

Internal Medicine

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lake Spring Physician Services, LLCGroup PAC ID 1254689482, 89 clinicians

Hospitalist Physicians Medical Group of Michigan, PCGroup PAC ID 4688778228, 18 clinicians

24 On Physicians PCGroup PAC ID 5698688141, 274 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wyandotte Hospital and Medical Center Hospital, Wyandotte, MI, CCN 230146
• Lewisgale Medical Center Hospital, Salem, VA, CCN 490048
• St John'S Episcopal Hospital at South Shore Hospital, Far Rockaway, NY, CCN 330395
• Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: msanmartingomez295464@direct.myadvocateaurora.org
• Direct secure messaging: mario.sanmartingomez@marshfieldclinichealthsystem.cernerdirect.com
• Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com
• Direct secure messaging: msanmartingomez221157@direct.hfhs.org

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.

• 24 On Physicians, PC

  • Hospitalist Physician
  • Far Rockaway, NY
  • NPI 1578781787
  Medicare reassignment Care Compare group NPD
• Hospitalist Physicians Medical Group of Michigan, PC

  • Emergency Medicine Physician
  • Chelsea, MI
  • NPI 1003978867

  Hospitalist

  Medicare reassignment Care Compare group NPD
• Lake Spring Physician Services, LLC

  • Hospitalist Physician
  • Salem, VA
  • NPI 1568954287
  Medicare reassignment Care Compare group
• Lee Health System Inc

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1942058557
  Medicare reassignment NPD
• Lee Memorial Health System

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1992873319
  Medicare reassignment NPD
• Aspirus Wausau Hospital, Inc.

  • Clinic/Center
  • Wausau, WI
  • NPI 1922321140

  Internal Medicine

  Medicare reassignment NPD
• Hospitalist Medicine Physicians of Michigan, PLLC

  • Internal Medicine Physician
  • Adrian, MI
  • NPI 1013180181
  Medicare reassignment NPD
• Marshfield Clinic Inc

  • Clinic/Center
  • Marshfield, WI
  • NPI 1952347981
  Medicare reassignment NPD
• MCHS Hospitals Inc

  • Clinic/Center
  • Marshfield, WI
  • NPI 1093221434

  Internal Medicine

  Medicare reassignment NPD
• Sound Inpatient Physicians-Michigan, PLLC

  • Internal Medicine Physician
  • Kalamazoo, MI
  • NPI 1093967861
  Medicare reassignment NPD
• Lee Health System Inc

  • Community/Retail Pharmacy
  • Bonita Springs, FL
  • NPI 1699510925
  NPD
• Lee Memorial Health System

  • Federally Qualified Health Center (FQHC)
  • Port Charlotte, FL
  • NPI 1255171765
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Care Compare affiliation
• Henry Ford Wyandotte Hospital

  • Ambulatory Surgical Clinic/Center
  • Wyandotte, MI
  • NPI 1093901035

  Hospital

  Care Compare affiliation
• Henry Ford Wyandotte Hospital

  • General Acute Care Hospital
  • Wyandotte, MI
  • NPI 1992725352
  Care Compare affiliation
• Lewis-Gale Medical Center, LLC

  • General Acute Care Hospital
  • Salem, VA
  • NPI 1619914785
  Care Compare affiliation

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

{
    "created_epoch": "1264636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1598096679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-424-3123",
            "fax_number": "239-424-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 DEL PRADO BLVD S",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339902668",
            "telephone_number": "239-424-3123",
            "fax_number": "239-424-4041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2333 Biddle Ave",
            "address_purpose": "LOCATION",
            "city": "Wyandotte",
            "state": "MI",
            "postal_code": "481924668",
            "country_code": "US",
            "telephone_number": "734-246-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "855 N Westhaven Dr",
            "address_purpose": "LOCATION",
            "city": "Oshkosh",
            "state": "WI",
            "postal_code": "549047668",
            "country_code": "US",
            "telephone_number": "920-303-8700",
            "fax_number": "920-456-7601",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 N Oak Ave",
            "address_purpose": "LOCATION",
            "city": "Marshfield",
            "state": "WI",
            "postal_code": "544495703",
            "country_code": "US",
            "telephone_number": "715-387-5511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAN MARTIN GOMEZ",
        "first_name": "MARIO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-28",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "70462",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301097702",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MI",
            "license": "4301097702",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WI",
            "license": "70462",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME157634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100141906",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msanmartingomez295464@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "855 N Westhaven Dr",
            "city": "Oshkosh",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549047668",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "855 N Westhaven Dr",
            "city": "Oshkosh",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549047668",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1000 N Oak Ave",
            "city": "Marshfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544495703",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Other",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "1000 N Oak Ave",
            "city": "Marshfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544495703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sam'S East, Inc.
• Samaritan Health and Wellness Center, Inc
• Ayman Samir
• Rafaella Sampaio, DMD
• Sams East Inc
• Kevin San Martin
• Raul Cesar San Roman
• Donna San Salvador, MA, NCC
• Arianna Hope Sanborn, APN
• Dayana V Sanchez Cabrera

• Hospitalist Physician in Cape Coral, FL
• Providers in Cape Coral, FL by specialty
• Hospitalist Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; 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.