Individual provider Active NPI

Beth S Gomez, P.T.

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Irvine, CA
National Provider Identifier
1861524688
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X
License
PT26517 Issued in CA
Practice address
6865 Alton Pkwy
Suite 110
Irvine, CA 92618-3735
Phone
(949) 727-1858
Fax
(949) 727-1868
NPI assigned
Mar 9, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

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
Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X PT26517 CA Primary

Addresses

Primary practice location

6865 Alton Pkwy
Suite 110
Irvine, CA 92618-3735

Mailing address

PO Box 8125
Fountain Valley, CA 92728-8125
Phone (949) 727-1858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT26517CAMDSports Medicine (Neuromusculoskeletal Medicine) Physician
26517CAMDCritical Care Certified Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mobilpt, Inc. Past 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": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861524688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8125",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927288125",
            "telephone_number": "949-727-1858",
            "fax_number": "949-727-1868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6865 ALTON PKWY",
            "address_2": "SUITE 110",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183735",
            "telephone_number": "949-727-1858",
            "fax_number": "949-727-1868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "BETH",
        "middle_name": "S",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "CA",
            "license": "PT26517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.