Individual provider Active NPI

Alfonso Angel Gomar, MD

  • Internal Medicine Physician
  • Annapolis, MD
National Provider Identifier
1700916152
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M D036246L Issued in PA
Practice address
2114 Generals Hwy
Annapolis, MD 21401-7488
Phone
(888) 808-6483
Fax
(410) 721-2656
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M D036246L PA Primary

Addresses

Primary practice location

2114 Generals Hwy
Annapolis, MD 21401-7488

Mailing address

PO Box 6725
Annapolis, MD 21401-0725
Phone (888) 808-6483

Other identifiers 1

IdentifierTypeStateIssuer
0007152350002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M D036246LPAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1700916152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6725",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214010725",
            "telephone_number": "888-808-6483",
            "fax_number": "410-721-2656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 GENERALS HWY",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017488",
            "telephone_number": "888-808-6483",
            "fax_number": "410-721-2656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMAR",
        "first_name": "ALFONSO",
        "middle_name": "ANGEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "M D036246L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007152350002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.