Lourdes Carolina Gomez, RD is a medicare enrolled "Dietitian, Registered" provider in Montclair, California. Her current practice location is
9612 Helena Ave, Montclair, California. You can reach out to her office (for appointments etc.) via phone at
(909) 541-8612.
Lourdes Carolina Gomez is licensed to practice in California (license number 86169226) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1104498328.
Healthcare Provider's Profile
| Full Name | Lourdes Carolina Gomez |
|---|
| Gender | Female |
|---|
| Speciality | Dietitian, Registered |
|---|
| Location | 9612 Helena Ave, Montclair, California |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1104498328
- Provider Enumeration Date: 07/15/2021
- Last Update Date: 07/08/2024
Medicare PECOS Information:
- PECOS PAC ID: 6305289877
- Enrollment ID: I20240723003810
Medical Identifiers
Medical identifiers for Lourdes Carolina Gomez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1104498328 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 133V00000X | Dietitian, Registered | 86169226 (California) | Primary |
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. Lourdes Carolina Gomez allows following entities to bill medicare on her behalf.
| Provider Name | Northeast Community Clinic |
|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
|---|
| Provider Identifiers | NPI Number: 1700097540
PECOS PAC ID: 5193710275
Enrollment ID: O20040417000619 |
|---|
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. Lourdes Carolina 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 |
|---|
Lourdes Carolina Gomez, RD
3775 E 11th St,
Long Beach, CA 90804-6430
Ph: (909) 541-8612 | Lourdes Carolina Gomez, RD
9612 Helena Ave,
Montclair, CA 91763-2210
Ph: (909) 541-8612 |
Reviews and Comments