Edwin Antonio Gomez, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME97741 Issued in FL

Practice address

1040 Weston Rd
Suite 210
Weston, FL 33326-1912

Phone

(954) 766-4702

Fax

(954) 766-4907

NPI assigned

Sep 28, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

David Lawrence Mental Health Center, IncGroup PAC ID 0547257313, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• David Lawrence Mental Health Center, Inc

  • Community/Behavioral Health Agency
  • Naples, FL
  • NPI 1801891940
  Medicare reassignment Care Compare group NPD
• Banyan Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Coral Gables, FL
  • NPI 1104247188
  Medicare reassignment NPD
• Elite Psychiatric Associates PA

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hialeah, FL
  • NPI 1285366823
  Medicare reassignment NPD
• Guidance/Care Center, Inc.

  • Community/Behavioral Health Agency
  • Marathon, FL
  • NPI 1184627739
  Medicare reassignment NPD
• Legacy Behavioral Health Center Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Indiantown, FL
  • NPI 1568439685
  Medicare reassignment NPD
• Goal Psychiatric Associates, LLC

  • Psychiatry Physician
  • Weston, FL
  • NPI 1427338680
  Authorized official Same address or phone
• Banyan Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Lauderdale Lakes, FL
  • NPI 1972979631
  NPD
• Guidance/Care Center, Inc.

  • Special Hospital
  • Marathon, FL
  • NPI 1720845407
  NPD
• Legacy Behavioral Health Center Inc

  • Community/Behavioral Health Agency
  • Okeechobee, FL
  • NPI 1083381552
  NPD
• Banyan Community Health Center, Inc.

  • Community/Behavioral Health Agency
  • Coral Gables, FL
  • NPI 1710394499
  NPD (past)

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389571200000",
    "number": "1780775098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 WESTON RD",
            "address_2": "STE 210",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333261912",
            "telephone_number": "954-766-4702",
            "fax_number": "954-766-4907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 WESTON RD",
            "address_2": "SUITE 210",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333261912",
            "telephone_number": "954-766-4702",
            "fax_number": "954-766-4907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "EDWIN",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2014-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME97741",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "FL",
            "license": "ME97741",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001441900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE PTAN",
            "identifier": "GM814A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marc Goldstein, MPT
• Viktoriia Golikova, MD
• Yedda M Gomes-Ruane, DMD
• Jomaries Ohamy Gomez Rosado
• Juan Pablo Gomez-Sanchez
• Karina E. Gomez, MD, PHD
• Magaly M Gomez
• Jhezanuel Carolina Goncalves Cordero, DMD
• Edwin Jose Gonzalez Sanchez, FNP
• Ada Gonzalez, P.T.

• Psychiatry Physician in Weston, FL
• Providers in Weston, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.