Johnny Edward Gomez, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9105188 Issued in FL

Practice address

2250 NW 136TH Ave Ste 100
Pembroke Pines, FL 33028-2628

Phone

(954) 302-7960

Fax

(954) 628-5084

NPI assigned

Dec 27, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Rgpmd, LLC

  • Internal Medicine Physician
  • Pembroke Pines, FL
  • NPI 1538594320
  Medicare reassignment

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

{
    "created_epoch": "1261872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1699005538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 NW 136TH AVE STE 100",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330282628",
            "telephone_number": "954-302-7960",
            "fax_number": "954-628-5084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 NW 136TH AVE STE 100",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330282628",
            "telephone_number": "954-302-7960",
            "fax_number": "954-628-5084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "JOHNNY",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-27",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9105188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlos Manuel Gomez, APRN
• Daniel A Gomez, MD
• Daniela Gomez
• Isabel C Gomez
• Jackeline Gomez
• Katherine Gomez
• Martha Gomez
• Priscilla Gomez
• Toni Leigh Gomez, APRN
• Vianka Alessandra Gomez

• Medical Physician Assistant in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.