Gelys Gongora

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN11014674 Issued in FL

Practice address

6107 Memorial Hwy
Tampa, FL 33615-4596

Phone

(813) 890-3400

NPI assigned

Aug 27, 2021

Last updated

Aug 27, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

All facility ownership & control disclosures 1

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

Owned or controlled facilities with NPI records 1

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

• Divine Home Health Care, Inc

  • Home Health Agency
  • Tampa, FL
  • NPI 1801066071

  5% Or Greater Direct Ownership Interest

  CMS ownership

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.

• Medway Medical Centers LLC

  • Family Medicine Physician
  • New Port Richey, FL
  • NPI 1669063475
  Medicare reassignment NPD
• Divine Home Health Care, Inc

  • Home Health Agency
  • Oldsmar, FL
  • NPI 1063894798
  NPD Authorized official
• Harvest Medical Services

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1780572586
  NPD Authorized official
• Divine Home Health Group, Inc

  • Home Health Agency
  • Tampa, FL
  • NPI 1972988293
  Authorized official Same address or phone
• Divine Home Health Care, Inc

  • Home Health Agency
  • Tampa, FL
  • NPI 1801066071
  NPD
• Divine Care Management LLC

  • Nurse Practitioner
  • Clearwater, FL
  • NPI 1427601491
  NPD (past)
• Medway Medical Centers of Clearwater LLC

  • Family Medicine Physician
  • Clearwater, FL
  • NPI 1962192716
  NPD (past)

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

{
    "created_epoch": "1630022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1912674805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6107 MEMORIAL HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336154596",
            "telephone_number": "813-890-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6107 MEMORIAL HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336154596",
            "telephone_number": "813-890-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONGORA",
        "first_name": "GELYS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-27",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11014674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Denisse Gomez
• Victor Hugo Gomez, DC
• Virginia Gomez, BA
• Sandra Gonzalez Gompf, M.D.
• Yan Gong, A.P.
• Samantha Gongora
• Charlotte H Gonnering, LMHC
• Jessica Gonsalves
• Roman Gonta
• Heather Gonyea-Evans, RMHCI

• Nurse Practitioner in Tampa, FL
• Providers in Tampa, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.