NPIMap

Individual provider Active NPI

Carmen Andrea Tamayo Gomez, M.D

  • Family Medicine Physician
  • Mount Kisco, NY
National Provider Identifier
1902249014
Registry record updated Feb 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
00286162 Issued in NY
Practice address
30 W Main St
Mount Kisco, NY 10549-1910
Phone
(914) 666-3272
NPI assigned
Apr 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2017

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 00286162 NY Primary

Addresses

Primary practice location

30 W Main St
Mount Kisco, NY 10549-1910

Mailing address

165 Main St
Ossining, NY 10562-4702
Phone (914) 941-1263

Other identifiers 1

IdentifierTypeStateIssuer
04551066MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20161011001932 NY Practitioner - Family Practice 9638467434 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

10 Cranberry Dr
Hopewell Junction, NY 12533-5367
Phone (845) 231-5600

Hospital & facility affiliations

  • Health Quest Home Care, Inc (Certified) Chha Home health agency, Poughkeepsie, NY, CCN 337230
  • Prime Home Health Services, LLC Home health agency, Brooklyn, NY, CCN 337190
  • Americare Certified Special Services, Inc Chha Home health agency, Brooklyn, NY, CCN 337290
  • Hudson Valley Hospice Hospice, Poughkeepsie, NY, CCN 331521
  • Vassar Brothers Medical Center Hospital, Poughkeepsie, NY, CCN 330023

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00286162NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Jan 11, 2021 Accepting new patients
Optum Medical Care, P.C. CurrentSince Jan 11, 2021 Accepting new patients
Mount Kisco Medical Group Past Accepting new patients

Locations

10 Cranberry Dr
Hopewell Junction, NY 12533
Phone (845) 705-5097

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

Philadelphia, PA 19195

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: ctamayo142032@direct.optum.com

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 7

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": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485993600000",
    "number": "1902249014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 MAIN ST",
            "city": "OSSINING",
            "state": "NY",
            "postal_code": "105624702",
            "telephone_number": "914-941-1263",
            "fax_number": "914-941-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W MAIN ST",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105491910",
            "telephone_number": "914-666-3272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMAYO GOMEZ",
        "first_name": "CARMEN",
        "middle_name": "ANDREA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-09",
        "last_updated": "2017-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "00286162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04551066",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Kisco, NY

Sources for this page

Verify at the official NPI Registry.