Individual provider Active NPI

Danielle E. Gomez, PA-C

  • Surgical Physician Assistant
  • Evanston, IL
National Provider Identifier
1770112302
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
085007880 Issued in IL
Practice address
2650 Ridge Ave
Evanston, IL 60201-1700
Phone
(847) 570-1440
Fax
(847) 570-1442
NPI assigned
Apr 6, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085007880 IL
Surgical Physician Assistant 363AS0400X 085007880 IL Primary

Addresses

Primary practice location

2650 Ridge Ave
Evanston, IL 60201-1700

Mailing address

2650 Ridge Ave Ste 1223
Evanston, IL 60201-1700
Phone (847) 570-2040

Other practice location 1

9650 Gross Point Rd Ste 2900
Skokie, IL 60076-5006
Phone (847) 570-1440

Other practice location 2

7438 W Jonquil Ter
Niles, IL 60714-3104
Phone (224) 419-1795

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20210108001196 IL Practitioner - Physician Assistant 7517370661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

1300 Oak Ave
Evanston, IL 60201-4205
Phone (847) 869-1300

2650 Ridge Ave
Evanston, IL 60201-1700

Hospital & facility affiliations

  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085007880ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Oct 6, 2020 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

9650 Gross Point Rd
Ste 2900
Skokie, IL 60076

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1770112302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE STE 1223",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-570-2040",
            "fax_number": "847-733-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-570-1440",
            "fax_number": "847-570-1442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9650 Gross Point Rd Ste 2900",
            "address_purpose": "LOCATION",
            "city": "Skokie",
            "state": "IL",
            "postal_code": "600765006",
            "country_code": "US",
            "telephone_number": "847-570-1440",
            "fax_number": "847-570-1442",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7438 W Jonquil Ter",
            "address_purpose": "LOCATION",
            "city": "Niles",
            "state": "IL",
            "postal_code": "607143104",
            "country_code": "US",
            "telephone_number": "224-419-1795",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "DANIELLE",
        "middle_name": "E.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-06",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085007880",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085007880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.