Individual provider Active NPI

Ana Maria Gomez, M.D

  • Diagnostic Radiology Physician
  • Manati, PR
National Provider Identifier
1821253428
Registry record updated Jan 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
020757 Issued in PR
Practice address
Calle F Vegas Jimenez
Manati Medical Center
Manati, PR 00674
Phone
(310) 926-8524
NPI assigned
Jul 23, 2008
Last updated
Jan 19, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 020757 PR Primary
Diagnostic Radiology Physician 2085R0202X A110112 CA

Addresses

Primary practice location

Calle F Vegas Jimenez
Manati Medical Center
Manati, PR 00674

Mailing address

J22 Calle J
Villacaparra
Guaynabo, PR 00966-2203
Phone (310) 926-8524

Other identifiers 1

IdentifierTypeStateIssuer
0A1101120MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20131127000204 PR Practitioner - Diagnostic Radiology 0941462832 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A110112CAMDDiagnostic Radiology Physician
020757PRMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SHC Owner LLC Diagnostic Radiology CurrentSince Jan 30, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484784000000",
    "number": "1821253428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "J22 CALLE J",
            "address_2": "VILLACAPARRA",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009662203",
            "telephone_number": "310-926-8524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE F VEGAS JIMENEZ",
            "address_2": "MANATI MEDICAL CENTER",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "00674",
            "telephone_number": "310-926-8524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "ANA MARIA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-23",
        "last_updated": "2017-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PR",
            "license": "020757",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A110112",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0A1101120",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manati, PR

Sources for this page

Verify at the official NPI Registry.