Individual provider Active NPI

Rosa Maria Gomez, M.D.

  • Family Medicine Physician
  • Palmdale, CA
National Provider Identifier
1801919220
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A94489 Issued in CA
Practice address
2260 E Palmdale Blvd Ste H
Palmdale, CA 93550-1327
Phone
(661) 272-3777
Fax
(661) 272-9107
NPI assigned
Apr 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A94489 CA Primary

Addresses

Primary practice location

2260 E Palmdale Blvd Ste H
Palmdale, CA 93550-1327

Mailing address

1809 Amberidge Way
Palmdale, CA 93551-5001
Phone (661) 272-8941

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20070905000265 CA Practitioner - Family PracticePractitioner - Internal Medicine 8426141672 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Internal Medicine
Education
University of California, Geffen School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
High Desert Medical CorporationGroup PAC ID 6103730569, 58 clinicians
Anas Entabi MD IncGroup PAC ID 7012208093, 2 clinicians

Practice addresses (Care Compare)

43839 15TH St W
Lancaster, CA 93534-4756
Phone (661) 945-5984

540 W Palmdale Blvd
Suite B
Palmdale, CA 93551-4232
Phone (661) 274-9900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A94489CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anas Entabi M.D., Inc Family Medicine CurrentSince Jul 1, 2016 Accepting new patients

Locations

540 W Palmdale Blvd
#B
Palmdale, CA 93551
Phone (661) 274-9900

38925 Trade Center Dr
Unit H
Palmdale, CA 93551
Phone (661) 274-9900

Interoperability endpoints

  • Direct secure messaging: rosa.gomez.p4@direct.hdmgipa.nextgenshare.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801919220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 AMBERIDGE WAY",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935515001",
            "telephone_number": "661-272-8941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2260 E PALMDALE BLVD STE H",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935501327",
            "telephone_number": "661-272-3777",
            "fax_number": "661-272-9107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "ROSA",
        "middle_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A94489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

Verify at the official NPI Registry.