Individual provider Active NPI

Cassaundra Michelle Gomez, OTD, OTR/L

  • Occupational Therapist
  • Chandler, AZ
National Provider Identifier
1639905672
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTH-009741 Issued in AZ
Practice address
3160 N Arizona Ave Ste 106
Chandler, AZ 85225-7122
Phone
(480) 699-4845
NPI assigned
Sep 9, 2024
Last updated
Sep 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OTH-009741 AZ Primary
Neurorehabilitation Occupational Therapist 225XN1300X OTH-009741 AZ

Addresses

Primary practice location

3160 N Arizona Ave Ste 106
Chandler, AZ 85225-7122

Mailing address

3411 N 16TH St Apt 1088
Phoenix, AZ 85016-7168
Phone (623) 205-7842

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241017003511 AZ Practitioner - Occupational Therapist in Private Practice 6507398393 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OTH-009741AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Neurologic Rehabilitation CurrentSince Sep 5, 2024 Accepting new patients
Advanced Neurologic Rehabilitation CurrentSince Sep 5, 2024 Accepting new patients

Locations

3160 N Arizona Ave
Ste 106
Chandler, AZ 85225
Phone (480) 699-4845

3961 E Guadalupe Rd
Ste 1
Gilbert, AZ 85234
Phone (480) 699-4845

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1725840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1639905672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3411 N 16TH ST APT 1088",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167168",
            "telephone_number": "623-205-7842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3160 N ARIZONA AVE STE 106",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852257122",
            "telephone_number": "480-699-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "CASSAUNDRA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-09",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "OTH-009741",
            "primary": true
        },
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "AZ",
            "license": "OTH-009741",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.