Tiffany Madison Angelica Gomez, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.007067RX Issued in OH

Practice address

6421 Squirrel Nest Dr
Lorain, OH 44053-4344

Phone

(440) 984-1354

NPI assigned

Feb 5, 2021

Last updated

Sep 29, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michael Yerukhim MD LLCGroup PAC ID 9830583582, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southwest General Health Center Hospital, Middleburg Heights, OH, CCN 360155

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Michael Yerukhim, MD LLC

  dba Michael Yerukhim, MD

  • Otolaryngology/Facial Plastic Surgery Physician
  • Middleburg Heights, OH
  • NPI 1578023784
  Medicare reassignment Care Compare group

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

• Southwest General Health Center

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1154353993
  Care Compare affiliation

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

{
    "created_epoch": "1612483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1871185421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 LEAVITT RD",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440532421",
            "telephone_number": "440-984-1354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6421 SQUIRREL NEST DR",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440534344",
            "telephone_number": "440-984-1354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "TIFFANY",
        "middle_name": "MADISON ANGELICA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-05",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.007067RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Lorain",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6421 Squirrel Nest Dr",
            "city": "Lorain",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440534344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Juanita Glover, OTA/L
• Tyra Goines
• Donna Kay Goldsmith, RN
• Alan Golowenski
• Dominic Gomes, M.D
• Gesenia Gonzalez
• Hannah Grace Gonzalez, MT-BC
• Laura Gonzalez
• Sabrina Gonzalez
• Selena Marie Gonzalez

• Physician Assistant in Lorain, OH
• Providers in Lorain, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.