Elisha Grace Gomez, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

027161 Issued in NY

Practice address

6915 Yellowstone Blvd Ste 4
Forest Hills, NY 11375-3787

Phone

(718) 360-9550

NPI assigned

Oct 4, 2021

Sex

Female

Sole proprietor

No

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 NY

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

Physician Assistant

State licenses

Practice roles (1 of 5)

Networks

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

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.

• Advanced Physicians P C

  • Multi-Specialty Clinic/Center
  • Forest Hills, NY
  • NPI 1346563582

  NY

  Medicare reassignment
• New York Medicine Doctors, PLLC.

  • Multi-Specialty Clinic/Center
  • New York, NY
  • NPI 1831581628
  NPD (past)

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

{
    "created_epoch": "1633305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1972275261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6915 YELLOWSTONE BLVD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113759406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6915 YELLOWSTONE BLVD STE 4",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753787",
            "telephone_number": "718-360-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "ELISHA GRACE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-04",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "027161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Faraidoon Daniel Golyan, DO
• Joseph Golyan, MD
• Mary Jacqueline Gomez Cosse, MS
• Laura Maria Gomez Rodriguez
• Dalisa Gomez-Rodriguez
• Elizabeth Gomez
• Mery Concepcion Gomez, M.D., MPH
• Xavier Gomez
• Isabel Mariana Goncalves
• Maryknoll Tauro Gonsalves

• All providers in Forest Hills, NY
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.