NPIMap

Individual provider Active NPI

Gina Gomez, M.D.

  • Internal Medicine Physician
  • Skowhegan, ME
National Provider Identifier
1891714317
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD14310 Issued in ME
Practice address
46 Fairview Ave
Skowhegan, ME 04976-1481
Phone
(207) 474-5121
Fax
(207) 858-2415
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD14310 ME Primary

Addresses

Primary practice location

46 Fairview Ave
Skowhegan, ME 04976-1481

Mailing address

PO Box 468
Skowhegan, ME 04976-0468
Phone (207) 474-5121

Other identifiers 1

IdentifierTypeStateIssuer
1891714317MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040318000235 ME Practitioner - Internal Medicine 8325938806 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Redington-Fairview General HospitalGroup PAC ID 9133018740, 50 clinicians

Practice addresses (Care Compare)

46 Fairview Ave
Skowhegan, ME 04976-1481
Phone (207) 474-5121

Hospital & facility affiliations

  • Redington Fairview General Hospital Hospital, Skowhegan, ME, CCN 201314
  • Northern Light Eastern Maine Medical Center Hospital, Bangor, ME, CCN 200033
  • Redington Fairview General Hospital Nursing home, CCN 20Z314

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Redington-Fairview General Hospital CurrentSince Feb 1, 2004 Accepting new patients
Redington-Fairview General Hospital CurrentSince Feb 1, 2004 Accepting new patients
Redington Medical Associates Past Accepting new patients

Locations

46 Fairview Ave
Skowhegan, ME 04976
Phone 2074745121293

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Redington-Fairview General HospitalSkowhegan, ME, CCN 201314 Hospital Corporate Director May 1, 2008
Redington-Fairview General HospitalSkowhegan, ME, CCN 20Z314 Hospital Corporate Director May 1, 2008
Rural Health Family CareMadison, ME, CCN 208506 Rural health clinic Corporate Director May 1, 2008

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 3

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1891714317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 468",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "049760468",
            "telephone_number": "207-474-5121",
            "fax_number": "207-858-2415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 FAIRVIEW AVE",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "049761481",
            "telephone_number": "207-474-5121",
            "fax_number": "207-858-2415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "GINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "MD14310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891714317",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skowhegan, ME

Sources for this page

Verify at the official NPI Registry.