Individual provider Active NPI

Shirley Gomez, FNP-BC

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1760199897
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
350377 Issued in NY
Practice address
4813 9TH Ave FL 5
Brooklyn, NY 11220-2484
Phone
(718) 283-2550
NPI assigned
Oct 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 350377 NY Primary

Addresses

Primary practice location

4813 9TH Ave FL 5
Brooklyn, NY 11220-2484

Mailing address

4802 10TH Ave
Brooklyn, NY 11219-2916
Phone (718) 283-2550

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20250609002476 NY Practitioner - Nurse Practitioner 4486164449 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Century Medical and Dental Center IncGroup PAC ID 8729070669, 107 clinicians

Practice addresses (Care Compare)

425 Westchester Ave
Bronx, NY 10455-1795
Phone (718) 705-2555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
350377NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Century Medical & Dental Center Inc CurrentSince Aug 1, 2025 Accepting new patients
MMC Pediatrics Faculty Practice CurrentSince Mar 6, 2025 Accepting new patients
Maimonides Faculty Practice Plan CurrentSince Mar 6, 2025 Accepting new patients
Maimonides Medical Center Division of Otolaryngology FPP PastSince Oct 1, 2013 Accepting new patients
Suny Downstate Medical Center Past Accepting new patients

Locations

425 Westchester Ave
Bronx, NY 10455
Phone (347) 343-0568

745 64th St
Brooklyn, NY 11220
Phone (718) 765-2570

1250 57th St
Brooklyn, NY 11219
Phone (718) 283-5700

6300 8th Ave
Brooklyn, NY 11220
Phone (718) 765-2600

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

260 Avenue X
Brooklyn, NY 11223
Phone (718) 336-8855

948 48th St
Brooklyn, NY 11219
Phone (718) 283-7219

919 49th St
Brooklyn, NY 11219
Phone (718) 283-6260

6323 7th Ave
Brooklyn, NY 11220
Phone (718) 283-6980

200 Livingston St
Brooklyn, NY 11201
Phone (718) 522-3399

2315 3rd Ave
New York, NY 10035
Phone (212) 369-5566

827 11th Ave
New York, NY 10019
Phone (212) 257-9778

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Organizations & group practices 5

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": "1666915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1760199897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4802 10TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192916",
            "telephone_number": "718-283-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4813 9TH AVE FL 5",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112202484",
            "telephone_number": "718-283-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "SHIRLEY",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-28",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "350377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.