Ivonne Antonia Gomez, PA
Physician Assistant in Bronx, NY. Individual provider (NPI-1).
NPI number1801255286
StatusActive
Last updated in NPPESFeb 15, 2016
Details
- NPI
- 1801255286
- Entity type
- Individual (NPI-1)
- Name
- Ivonne Antonia Gomez
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 15, 2016
- Last updated
- Feb 15, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 0194301 | NY | Yes |
Practice location
111 E 210th StBronx, NY 10467-2401
Phone 718-920-2146
Mailing address
3164 34th StApt B3
Astoria, NY 11106-1793
Phone 917-569-5836
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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