Organization Active NPI

Gomezcare Inc

  • Geriatric Psychiatry Physician
  • Jacksonville, FL
National Provider Identifier
1750553160
Registry record updated Aug 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
License
ME 37948 Issued in FL
Legal business name
GOMEZCARE INC
Practice address
4217 Baymeadows Rd
Suite #3
Jacksonville, FL 32217-4676
Phone
(904) 332-7431
Fax
(904) 332-7408
NPI assigned
Mar 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2010

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

Authorized official

Name
Jose Maria Gomez, M.D.NPI 1811929532
Title
President-Owner
Phone
(904) 332-7431

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0805X ME 37948 FL Primary

Addresses

Primary practice location

4217 Baymeadows Rd
Suite #3
Jacksonville, FL 32217-4676

Mailing address

4217 Baymeadows Rd
Suite#3
Jacksonville, FL 32217-4676
Phone (904) 332-7431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080725000597 FL Part B Supplier - Clinic/Group Practice 3476626284 Receives reassigned benefits from 1 practitioner
Practice locations: Jacksonville, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283126400000",
    "number": "1750553160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4217 BAYMEADOWS RD",
            "address_2": "SUITE#3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174676",
            "telephone_number": "904-332-7431",
            "fax_number": "904-332-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4217 BAYMEADOWS RD",
            "address_2": "SUITE #3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174676",
            "telephone_number": "904-332-7431",
            "fax_number": "904-332-7408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOMEZCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-25",
        "last_updated": "2010-08-30",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "PRESIDENT-OWNER",
        "authorized_official_telephone_number": "904-332-7431",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "FL",
            "license": "ME 37948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.