Individual provider Active NPI

Karen Y Gomez, PT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1770795122
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070-004033 Issued in IL
Practice address
5701 N Sheridan Rd
Unit 21K
Chicago, IL 60660-4707
Phone
(773) 416-6443
NPI assigned
May 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070-004033 IL Primary

Addresses

Primary practice location

5701 N Sheridan Rd
Unit 21K
Chicago, IL 60660-4707

Mailing address

5701 N Sheridan Rd Apt 21K
Chicago, IL 60660-4707
Phone (773) 416-6443

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
070-004033ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Balanced Bodies LLC PastSince Nov 1, 2010 Accepting new patients
Manual Touch Physical Therapy Physical Therapist PastSince Aug 23, 2010 Accepting new patients
Centerimt Chicago Il PC Physical Therapist Past Accepting new patients

Organizations & group practices 3

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": "1178323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1770795122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 N SHERIDAN RD APT 21K",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606604707",
            "telephone_number": "773-416-6443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 N SHERIDAN RD",
            "address_2": "UNIT 21K",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606604707",
            "telephone_number": "773-416-6443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "KAREN",
        "middle_name": "Y",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-05",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-004033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2020; 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.