Individual provider Active NPI

Anilu Gomez, APRN

  • Family Nurse Practitioner
  • Clewiston, FL
National Provider Identifier
1861230062
Registry record updated Jul 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11033881 Issued in FL
Practice address
500 W Sagamore Ave
Clewiston, FL 33440-3514
Phone
(863) 983-3434
NPI assigned
Jul 20, 2024
Last updated
Jul 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11033881 FL Primary

Addresses

Primary practice location

500 W Sagamore Ave
Clewiston, FL 33440-3514

Mailing address

1095 Saturn CT
Labelle, FL 33935-9801
Phone (863) 517-1126

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240926001952 FL Practitioner - Nurse Practitioner 2668913930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Group practices
Hendry County Hospital AuthorityGroup PAC ID 8022912435, 17 clinicians

Practice addresses (Care Compare)

500 W Sagamore Ave
Clewiston, FL 33440-3514
Phone (863) 983-3434

524 W Sagamore Ave
Clewiston, FL 33440-3514

530 W Sagamore Ave
Clewiston, FL 33440-3514
Phone (863) 902-3069

532 W Sagamore Ave
Clewiston, FL 33440-3514
Phone (863) 902-3026

540 W Sagamore Ave
Hendry Regional Specialty Group
Clewiston, FL 33440-3514
Phone (863) 983-5026

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11033881FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hendry County Hospital Authority CurrentSince Aug 19, 2024 Accepting new patients
Hendry County Hospital Authority Current Accepting new patients
Hendry County Hospital Authority CurrentSince Aug 19, 2024 Accepting new patients
Hendry County Hospital Authority Past Accepting new patients

Locations

500 W Sagamore Ave
Clewiston, FL 33440
Phone (863) 902-3032

524 W Sagamore Ave
Clewiston, FL 33440
Phone (800) 494-3984

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1721433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721433600000",
    "number": "1861230062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1095 SATURN CT",
            "city": "LABELLE",
            "state": "FL",
            "postal_code": "339359801",
            "telephone_number": "863-517-1126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W SAGAMORE AVE",
            "city": "CLEWISTON",
            "state": "FL",
            "postal_code": "334403514",
            "telephone_number": "863-983-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "ANILU",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-20",
        "last_updated": "2024-07-20",
        "certification_date": "2024-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11033881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clewiston, FL

Sources for this page

Verify at the official NPI Registry.