Individual provider Active NPI

Michele S Gomez-Leffall, GRN

  • Attendant Care Provider
  • Duncanville, TX
National Provider Identifier
1659790756
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Attendant Care ProviderTaxonomy code 3747A0650X
Practice address
402 W Wheatland Rd Ste 180
Duncanville, TX 75116-4600
Phone
(469) 254-5346
Fax
(682) 759-5955
NPI assigned
Apr 16, 2014
Last updated
Mar 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU
State or Local Public Health Clinic/Center 261QP0905X NU
Attendant Care Provider 3747A0650X NU Primary
Licensed Vocational Nurse 164X00000X 308029 TX
Health Educator 174H00000X NU

Addresses

Primary practice location

402 W Wheatland Rd Ste 180
Duncanville, TX 75116-4600

Mailing address

402 W Wheatland Rd Ste 180
Duncanville, TX 75116-4600
Phone (469) 254-5346

Other practice location 1

402 W Wheatland Rd Ste 180
Duncanville, TX 75116-4600
Phone (469) 254-5346

Other identifiers 1

IdentifierTypeStateIssuer
1992393268MedicaidTX

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

State licenses

LicenseStateTypeSpecialty
308029TXMDLicensed Vocational Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Absolute Community Health, LLC CurrentSince Apr 6, 2021 Accepting new patients
Absolute CPR and Allied Health Training LLC Multi-Specialty CurrentSince Apr 6, 2021 Accepting new patients

Locations

402 W Wheatland Rd
Ste 180
Duncanville, TX 75116
Phone (469) 254-5346

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": "1397606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1659790756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 W WHEATLAND RD STE 180",
            "city": "DUNCANVILLE",
            "state": "TX",
            "postal_code": "751164600",
            "telephone_number": "469-254-5346",
            "fax_number": "682-759-5955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W WHEATLAND RD STE 180",
            "city": "DUNCANVILLE",
            "state": "TX",
            "postal_code": "751164600",
            "telephone_number": "469-254-5346",
            "fax_number": "682-759-5955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "402 W Wheatland Rd Ste 180",
            "address_purpose": "LOCATION",
            "city": "Duncanville",
            "state": "TX",
            "postal_code": "751164600",
            "country_code": "US",
            "telephone_number": "469-254-5346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOMEZ-LEFFALL",
        "first_name": "MICHELE",
        "middle_name": "S",
        "credential": "GRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-16",
        "last_updated": "2021-03-30",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "308029",
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992393268",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duncanville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.

Verify at the official NPI Registry.