Individual provider Active NPI

Elizabeth M Gomes, D.O.

  • Family Medicine Physician
  • Pawtucket, RI
National Provider Identifier
1730498171
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO00745 Issued in RI
Practice address
407 East Ave Ste 150
Pawtucket, RI 02860-5299
Phone
(401) 727-4800
NPI assigned
Oct 4, 2010
Last updated
Jun 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO00745 RI Primary

Addresses

Primary practice location

407 East Ave Ste 150
Pawtucket, RI 02860-5299

Mailing address

407 East Ave Ste 150
Pawtucket, RI 02860-5299
Phone (401) 727-4800

Other practice location 1

101 Dudley St
Providence, RI 02905-2401
Phone (401) 729-2304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140520000519 RI Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 0446402838 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO00745RIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blackstone Valley Community Health Care, Inc. CurrentSince Nov 1, 2016 Accepting new patients
Blackstone Valley Community Health Care, Inc. Past Accepting new patients
Jenks Park Pediatrics, Inc. PastSince Nov 3, 2019 Accepting new patients

Locations

1000 Broad St
Central Falls, RI 02863
Phone (401) 722-0081

9 Chestnut St
Central Falls, RI 02863
Phone (401) 722-0081

39 East Ave
Pawtucket, RI 02860
Phone (401) 722-0081

Interoperability endpoints

  • Direct secure messaging: elizabeth.gomes.p8@direct.bvchc.nextgenshare.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 4

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": "1286150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1730498171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 EAST AVE STE 150",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028605299",
            "telephone_number": "401-727-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 EAST AVE STE 150",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028605299",
            "telephone_number": "401-727-4800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Dudley St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029052401",
            "country_code": "US",
            "telephone_number": "401-729-2304",
            "fax_number": "401-729-2923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOMES",
        "first_name": "ELIZABETH",
        "middle_name": "M",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-04",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "DO00745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

Verify at the official NPI Registry.