Individual provider Active NPI

Sandra Raquel Gomes, PHD., BCBA-D

  • Behavior Analyst
  • Bedminster, NJ
National Provider Identifier
1770096497
Registry record updated Nov 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
1810 Burnt Mills Rd
Bedminster, NJ 07921-2672
Phone
(908) 719-6400
NPI assigned
Nov 16, 2017
Last updated
Nov 16, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

1810 Burnt Mills Rd
Bedminster, NJ 07921-2672

Mailing address

1301 Allen Rd
Somerset, NJ 08873-7488
Phone (908) 447-2904

Other identifiers 1

IdentifierTypeStateIssuer
1-13-14283OtherBEHAVIOR ANALYST CERTIFICATION BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Somerset Hills Learning Institute, Inc. Past Accepting new patients

Organizations & group practices 1

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": "1510790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510790400000",
    "number": "1770096497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 ALLEN RD",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088737488",
            "telephone_number": "908-447-2904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 BURNT MILLS RD",
            "city": "BEDMINSTER",
            "state": "NJ",
            "postal_code": "079212672",
            "telephone_number": "908-719-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMES",
        "first_name": "SANDRA",
        "middle_name": "RAQUEL",
        "name_prefix": "Dr.",
        "credential": "PHD., BCBA-D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-16",
        "last_updated": "2017-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIOR ANALYST CERTIFICATION BOARD",
            "identifier": "1-13-14283",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedminster, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.