Individual provider Active NPI

Jennice Gomez, OD

  • Optometrist
  • Huntington Park, CA
National Provider Identifier
1689569121
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT35962TLG Issued in CA
Practice address
6134 Pacific Blvd
Huntington Park, CA 90255-2923
Phone
(323) 589-3381
NPI assigned
Jun 12, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT35962TLG CA Primary

Addresses

Primary practice location

6134 Pacific Blvd
Huntington Park, CA 90255-2923

Mailing address

1144 W 149TH St
Gardena, CA 90247-3010
Phone (310) 918-6215

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251222000646 CA Practitioner - Optometry 6709371321 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Hernandez Optometry IncGroup PAC ID 0941785547, 5 clinicians

Practice addresses (Care Compare)

6134 Pacific Blvd
Huntington Park, CA 90255-2923
Phone (323) 589-3381

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35962CAMDEndodontist
OPT35962TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Hernandez Optometry Inc Optometrist CurrentSince Feb 4, 2026 Accepting new patients

Locations

6134 Pacific Blvd
Huntington Park, CA 90255
Phone (323) 589-3381

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1749686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1689569121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1144 W 149TH ST",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902473010",
            "telephone_number": "310-918-6215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6134 PACIFIC BLVD",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902552923",
            "telephone_number": "323-589-3381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "JENNICE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-12",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT35962TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Park, CA

Sources for this page

Verify at the official NPI Registry.