| Gustavo Gomez, MD | |
|
105 Opportunity Way, Lagrange, OH 44050-9018 | |
| (440) 222-4160 | |
| (440) 355-4213 |
| Full Name | Gustavo Gomez |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 14 Years |
| Location | 105 Opportunity Way, Lagrange, Ohio |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699031088 | NPI | - | NPPES |
| 0179466 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 35.128395 (Ohio) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ohioans Home Healthcare, Inc | Perrysburg, OH | Home health agency |
| Mercy Health-home Care, Lorain County | Lorain, OH | Home health agency |
| Mercy Allen Hospital | Oberlin, OH | Hospital |
| Mercy Regional Medical Center | Lorain, OH | Hospital |
| Cleveland Clinic | Cleveland, OH | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mercy Health-allen Hospital Llc | 5092802389 | 13 |
| Mercy Health Physicians Lorain Llc | 1355474172 | 41 |
| Entity Name | Mercy Health-allen Hospital Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801825997 PECOS PAC ID: 5092802389 Enrollment ID: O20080731000059 |
| Entity Name | Mercy Health Physicians Lorain Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023347192 PECOS PAC ID: 1355474172 Enrollment ID: O20100730000651 |
| Entity Name | Mercy Health Physicians Lorain Specialty Care Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972126381 PECOS PAC ID: 4688070055 Enrollment ID: O20210909003432 |
| Mailing Address | Practice Location Address |
|---|---|
| Gustavo Gomez, MD 1957 Cooper Foster Park Rd, Amherst, OH 44001-1207 Ph: (440) 989-3801 | Gustavo Gomez, MD 105 Opportunity Way, Lagrange, OH 44050-9018 Ph: (440) 222-4160 |