Active NPI
Glendaly Gomez, MD
- Physician Assistant
- Cidra, PR
National Provider Identifier
1629657267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 588-PA
- Practice address
- #105 Hospital Menonita
Cidra, PR 00739 - Phone
- (787) 739-6688
- NPI assigned
- Apr 2, 2021
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 588-PA | PR | Primary |
Addresses
Primary practice location
#105 Hospital Menonita
Cidra, PR 00739
Mailing address
HC 44 Box 13436
Cayey, PR 00736
Phone (787) 244-5105
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SSN | Other | PR | NO INTERESTED |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 588-PA | PR | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617321600000",
"number": "1629657267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HC 44 BOX 13436",
"city": "CAYEY",
"state": "PR",
"postal_code": "00736",
"telephone_number": "787-244-5105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "#105 HOSPITAL MENONITA",
"city": "CIDRA",
"state": "PR",
"postal_code": "00739",
"telephone_number": "787-739-6688"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "GLENDALY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-02",
"last_updated": "2021-04-02",
"certification_date": "2021-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PR",
"license": "588-PA",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NO INTERESTED",
"identifier": "SSN",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cidra, PR
- Ginebra Cardiovascular Diagnostic Services
- Juan Manuel Ginebra Vazquez
- Leticia Marie Girau-Colon, D.M.D.
- Gobierno Municipal de Cidra
- Golden Audiology Puerto Rico LLC
- Giselle Gonzalez Martinez
- Jeanna Marie Gonzalez Martinez
- Nayerllie Gonzalez Mejias
- Elena Gonzalez Ortiz, M.D.
- Estefany Gonzalez Rivera, LCSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.