Luis Alberto Gomez Vaca, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

71695 Issued in GA

Practice address

1107 Memorial Dr Ste 201
Dalton, GA 30720-8662

Phone

(706) 277-7311

Fax

(706) 272-3512

NPI assigned

Apr 25, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in GA, TN2 enrollments

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 2

Specialty

Family PracticeAlso: Dermatology

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

FPSC PLLCGroup PAC ID 0547557829, 2 clinicians

Skin Cancer and Cosmetic Dermatology Center PCGroup PAC ID 8224118773, 29 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

79.32 of 100Reported as group

Quality

64.03

Promoting interoperability

97

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: luis.gomez.1@24113.direct.athenahealth.com
• Direct secure messaging: luis.gomez.vaca@sccdc.gadirect.net

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.

• FPSC, PLLC

  • Family Medicine Physician
  • Hixson, TN
  • NPI 1841744810
  Medicare reassignment Care Compare group NPD
• Skin Cancer and Cosmetic Dermatology Center PC

  • Dermatology Physician
  • Chattanooga, TN
  • NPI 1144419458
  Medicare reassignment Care Compare group NPD
• Skin Cancer & Cosmetic Dermatology Center, PC

  • Dermatology Physician
  • Dalton, GA
  • NPI 1376605394
  Medicare reassignment NPD
• Sky One MD, PLLC

  • Dermatology Physician
  • Athens, TN
  • NPI 1306783196
  Medicare reassignment NPD

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

{
    "created_epoch": "1303689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1902197064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 MEMORIAL DR STE 201",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307208662",
            "telephone_number": "706-277-7311",
            "fax_number": "706-272-3512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 MEMORIAL DR STE 201",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307208662",
            "telephone_number": "706-277-7311",
            "fax_number": "706-272-3512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ VACA",
        "first_name": "LUIS",
        "middle_name": "ALBERTO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-25",
        "last_updated": "2023-11-27",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "71695",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11016108A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jychung@directaddress.net",
            "affiliation": "Y",
            "affiliationName": "Skin Cancer & Cosmetic Dermatology Center, PC",
            "address_1": "1107 Memorial Dr Ste 201",
            "city": "Dalton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "307208662",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jychung@directaddress.net",
            "affiliation": "Y",
            "affiliationName": "Skin Cancer and Cosmetic Dermatology Center PC",
            "address_1": "2253 Chambliss Ave NW",
            "address_2": "Suite 202",
            "city": "Cleveland",
            "state": "TN",
            "country_code": "US",
            "postal_code": "373113861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alison Gobel
• Kimberly Godfrey
• Christina Goering, LCSW, MSW
• Laura Goins, PA
• Esteban J Gomez Alvarez, MD
• Ashley Nicole Goniea
• Andiesky Gonzalez, PHARMD
• Juan Carlos Gonzalez, MD
• Karen Mireya Gonzalez, O.D.
• Good Hope Counseling PC

• Dermatology Physician in Dalton, GA
• Providers in Dalton, GA by specialty
• Dermatology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.