Carlos Manuel Gomez, APRN is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" provider in Pembroke Pines, Florida. His current practice location is
2010 Nw 150th Ave Ste 120, Pembroke Pines, Florida. You can reach out to his office (for appointments etc.) via phone at
(954) 719-6280.
Carlos Manuel Gomez is licensed to practice in Florida (license number 11007700) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1407466774.
Healthcare Provider's Profile
| Full Name | Carlos Manuel Gomez |
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| Gender | Male |
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| Speciality | Nurse Practitioner - Psychiatric/mental Health |
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| Location | 2010 Nw 150th Ave Ste 120, Pembroke Pines, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1407466774
- Provider Enumeration Date: 08/03/2020
- Last Update Date: 12/13/2023
Medicare PECOS Information:
- PECOS PAC ID: 0042622722
- Enrollment ID: I20201222002135
Medical Identifiers
Medical identifiers for Carlos Manuel Gomez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1407466774 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | APRN11007700 (Florida) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | APRN11007700 (Florida) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 11007700 (Florida) | Primary |
| 363LF0000X | Nurse Practitioner - Family | 11007700 (Florida) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Carlos Manuel Gomez allows following entities to bill medicare on his behalf.
| Entity Name | Westside Hospitalist Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1013022128
PECOS PAC ID: 0446214282
Enrollment ID: O20041112000217 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Carlos Manuel Gomez is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Carlos Manuel Gomez, APRN
4740 N State Road 7,
Lauderdale Lakes, FL 33319-5839
Ph: (954) 486-4005 | Carlos Manuel Gomez, APRN
2010 Nw 150th Ave Ste 120,
Pembroke Pines, FL 33028-2888
Ph: (954) 719-6280 |
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