Individual provider Active NPI

Roberto Gomez, FNP-BC

  • Family Nurse Practitioner
  • Lufkin, TX
National Provider Identifier
1609529700
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1069133 Issued in TX
Practice address
710 Gaslight Blvd Ste a
Lufkin, TX 75904-3187
Phone
(936) 639-0988
Fax
(936) 639-0991
NPI assigned
Jan 28, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1069133 TX
Family Nurse Practitioner 363LF0000X 1069133 TX Primary

Addresses

Primary practice location

710 Gaslight Blvd Ste a
Lufkin, TX 75904-3187

Mailing address

710 Gaslight Blvd Ste a
Lufkin, TX 75904-3187
Phone (936) 639-0988

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220330000639 TX Practitioner - Nurse Practitioner 8022404185 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.57 of 100Reported as group
Quality
82.69
Improvement activities
40
Cost
81.66

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Total Point - Desoto LLC Family CurrentSince May 16, 2023 Accepting new patients
Woodrome Medical PA CurrentSince May 25, 2022 Accepting new patients
Alabama-Coushatta Tribe of Texas PastSince Feb 16, 2022 Accepting new patients

Locations

1601 Elm St
Ste 4210
Dallas, TX 75201

1111 N Interstate 35 E
Desoto, TX 75115
Phone (469) 530-9220

1517 E Rusk St
Jacksonville, TX 75766
Phone (903) 339-2370

2826 S Henderson Blvd
Kilgore, TX 75662
Phone 4693417800 ext. 211

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CHCBCA

Organizations & group practices 3

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": "1643328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1609529700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 GASLIGHT BLVD STE A",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043187",
            "telephone_number": "936-639-0988",
            "fax_number": "936-639-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 GASLIGHT BLVD STE A",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043187",
            "telephone_number": "936-639-0988",
            "fax_number": "936-639-0991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "ROBERTO",
        "name_prefix": "Mr.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-28",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1069133",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1069133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lufkin, TX

Sources for this page

Verify at the official NPI Registry.