Juan Gabriel Gomez, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP10242 Issued in AZ

Practice address

5701 W Talavi Blvd Ste 180
Glendale, AZ 85306-1888

Phone

(480) 335-8010

NPI assigned

May 11, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Jewish Family and Childrens ServiceGroup PAC ID 9234028671, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Jewish Family & Children'S Service

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1023174455
  Medicare reassignment Care Compare group NPD
• Jewish Family & Children'S Service

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1609939214
  NPD
• Jewish Family & Children'S Service

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1801103841
  NPD

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1801322755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9219 W LOUISE DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853833542",
            "telephone_number": "480-335-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 W TALAVI BLVD STE 180",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853061888",
            "telephone_number": "480-335-8010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "JUAN",
        "middle_name": "GABRIEL",
        "name_prefix": "Mr.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP10242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Golden, RDN
• Goldwater Legacy Assisted Living LLC
• Ram Goli
• Richard L Golub, MD
• G. Reshmaal Deepthi Gomes Cumaranatunge, MD
• Matthew Gomez, LCSW
• Miquel Dean Gomez II, MD
• Salina Gomez, LAC
• Zyana Gomez
• Tealai Raechal Gonella

• Psychiatric/Mental Health Nurse Practitioner in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; 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.