Individual provider Active NPI

Ingrid Patricia Gomez, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1942495536
Registry record updated Jul 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
076872 Issued in NY
Practice address
227 Madison St
Medical Staff Office, R-1249
New York, NY 10002-7537
Phone
(212) 238-7614
Fax
(212) 238-7009
NPI assigned
Sep 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 076872 NY Primary

Addresses

Primary practice location

227 Madison St
Medical Staff Office, R-1249
New York, NY 10002-7537

Mailing address

227 Madison St
Medical Staff Office, R-1249
New York, NY 10002-7537
Phone (212) 238-7614

Other identifiers 1

IdentifierTypeStateIssuer
076872OtherNYNYS LICENSE#

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090908000389 NY Practitioner - Clinical Social Worker 1052466489 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
NYU Langone Hospitals CurrentSince Jan 27, 2023 Accepting new patients
NYU Langone Hospitals CurrentSince Jan 27, 2023 Accepting new patients

Locations

301 E 17th St
New York, NY 10003
Phone (212) 460-0125

Networks

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

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279843200000",
    "number": "1942495536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 MADISON ST",
            "address_2": "MEDICAL STAFF OFFICE, R-1249",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100027537",
            "telephone_number": "212-238-7614",
            "fax_number": "212-238-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 MADISON ST",
            "address_2": "MEDICAL STAFF OFFICE, R-1249",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100027537",
            "telephone_number": "212-238-7614",
            "fax_number": "212-238-7009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "INGRID",
        "middle_name": "PATRICIA",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-07",
        "last_updated": "2010-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "076872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE#",
            "identifier": "076872",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.