Individual provider Active NPI

Beatriz Gomez-Matta, M.D.

  • Family Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1861557209
Registry record updated Jun 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A94379 Issued in CA
Practice address
245 S Fetterly Ave
Los Angeles, CA 90022-1605
Phone
(323) 780-2216
Fax
(323) 264-3771
NPI assigned
Dec 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2015

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 A94379 CA Primary

Addresses

Primary practice location

245 S Fetterly Ave
Los Angeles, CA 90022-1605

Mailing address

245 S Fetterly Ave
Los Angeles, CA 90022-1605
Phone (323) 780-2216

Other names 1

  • Beatriz Gomez Former name

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
I20121023000590 CA Practitioner - Family Practice 3476703703 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Los AngelesGroup PAC ID 1850296534, 395 clinicians

Practice addresses (Care Compare)

245 S Fetterly Ave
Los Angeles, CA 90022-1605
Phone (323) 780-2216

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince Apr 23, 2018 Accepting new patients
County of Los Angeles CurrentSince Apr 23, 2018 Accepting new patients
County of Los Angeles Current Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

12021 Wilmington Ave
Rm 1059
Los Angeles, CA 90059
Phone (310) 668-5201

245 S Fetterly Ave
Los Angeles, CA 90022
Phone (323) 362-1010

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434499200000",
    "number": "1861557209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 S FETTERLY AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900221605",
            "telephone_number": "323-780-2216",
            "fax_number": "323-264-3771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 S FETTERLY AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900221605",
            "telephone_number": "323-780-2216",
            "fax_number": "323-264-3771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ-MATTA",
        "first_name": "BEATRIZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2015-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A94379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BEATRIZ",
            "last_name": "GOMEZ",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.