Individual provider Active NPI

Arnold A Gombiner, MD

  • Specialist
  • Tinley Park, IL
National Provider Identifier
1629044847
Registry record updated Aug 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
18425 W West Creek Dr
Ste F
Tinley Park, IL 60477-6767
Phone
(708) 444-8300
Fax
(708) 444-8301
NPI assigned
Feb 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X IL Primary

Addresses

Primary practice location

18425 W West Creek Dr
Ste F
Tinley Park, IL 60477-6767

Mailing address

18425 W West Creek Dr
Ste F
Tinley Park, IL 60477-6767
Phone (708) 444-8300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Associates LTD PastSince Aug 23, 2020 Accepting new patients

Interoperability endpoints

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

Organizations & group practices 1

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": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188259200000",
    "number": "1629044847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18425 W WEST CREEK DR",
            "address_2": "STE F",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604776767",
            "telephone_number": "708-444-8300",
            "fax_number": "708-444-8301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18425 W WEST CREEK DR",
            "address_2": "STE F",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604776767",
            "telephone_number": "708-444-8300",
            "fax_number": "708-444-8301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMBINER",
        "first_name": "ARNOLD",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2007-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.