Andres Eduardo Gomez Vargas, SA-C

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

License

19-413 Issued in GA

Practice address

2230 Line Dr
Lawrenceville, GA 30043-2602

Phone

(786) 553-6073

Fax

(678) 585-1136

NPI assigned

Oct 9, 2019

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

Other names 1

• Andres Eduardo Gomez Vargas Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Surgical Assistants Group of Atlanta LLC

  • Surgical Assistant
  • Lawrenceville, GA
  • NPI 1588322739
  NPD Authorized official

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

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1851933170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2550",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "750302550",
            "telephone_number": "214-227-2457",
            "fax_number": "214-764-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 LINE DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300432602",
            "telephone_number": "786-553-6073",
            "fax_number": "678-585-1136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ VARGAS",
        "first_name": "ANDRES",
        "middle_name": "EDUARDO",
        "credential": "SA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-09",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "GA",
            "license": "19-413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDRES",
            "last_name": "GOMEZ VARGAS",
            "middle_name": "EDUARDO",
            "credential": "SA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eric Goldklang, M.D.
• Charya Chhauv by Goldsmith, M.D.
• Gordon Goldstein, MD
• Lawrence H Goldstein, MD
• Golfvista One LLC
• Andreina Gomez
• Esther Gomez
• Stephanie C Gomez, FNP-C
• Steven L Goninan, D.C.
• James L Gonzales, PHD

• Surgical Assistant in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Surgical Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.