Individual provider Active NPI

Rachel Lindsey Gomez, P.A.

  • Medical Physician Assistant
  • Mount Kisco, NY
National Provider Identifier
1619202397
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
013613-1 Issued in NY
Practice address
30 W Main St
Mount Kisco, NY 10549-1910
Phone
(914) 632-2737
NPI assigned
Oct 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 013613-1 NY Primary

Addresses

Primary practice location

30 W Main St
Mount Kisco, NY 10549-1910

Mailing address

30 W Main St
Mount Kisco, NY 10549-1910
Phone (914) 632-2737

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161115000430 NY Practitioner - Physician Assistant 0648559617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Open Door Family Medical Center IncGroup PAC ID 7113835380, 61 clinicians

Practice addresses (Care Compare)

30 W Main St
Mount Kisco, NY 10549-1910
Phone (914) 632-2737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
013613-1NYMDSpeech-Language Pathologist

Practice roles (3 of 7)

OrganizationSpecialtyStatusNew patients
Open Door Family Medical Center Inc CurrentSince Dec 20, 2022 Accepting new patients
Open Door Family Medical Center, Inc. CurrentSince Dec 20, 2022 Accepting new patients
Open Door Family Medical Center, Inc. Past Accepting new patients

Locations

30 W Main St
Mount Kisco, NY 10549
Phone (914) 666-3272

165 Main St
Ossining, NY 10562
Phone (914) 941-1263

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: rachel.snider@odfmc.eclinicaldirectplus.com

Organizations & group practices 4

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": "1255392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1619202397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W MAIN ST",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105491910",
            "telephone_number": "914-632-2737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W MAIN ST",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105491910",
            "telephone_number": "914-632-2737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "RACHEL",
        "middle_name": "LINDSEY",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-13",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "013613-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Kisco, NY

Sources for this page

Verify at the official NPI Registry.