DIEGO FERNANDO GOMEZ LCAS-A
NPI 1275914111
Counselor - Mental Health in Fort Myers, FL

Q: What is Diego Gomez's NPI number?

The NPI number for Diego Gomez is 1275914111. It was assigned to this individual provider in the NPPES registry on June 16, 2015.

Q: What is Diego Gomez's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Diego Gomez was last updated on September 3, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 16, 2015PECOS Enrolled

15901 BASS RD STE 108, FORT MYERS, FL 33908(239) 343-6050(239) 343-6051 Get Directions Write a Review

NPPES record last updated: September 3, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 3, 2020, Nov 2, 2018 (2 updates tracked since 2018).

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About Diego Fernando Gomez Lcas-a NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DIEGO FERNANDO GOMEZ LCAS-A (NPI 1275914111) is an individual mental health provider in Fort Myers, Florida, licensed in Florida (MH14194) and active in the NPI registry since June 2015. He is enrolled in Medicare PECOS and maintains a secondary practice location in Reidsville.

NPPES Registry Identity

NPI1275914111

Entity TypeIndividualMale

Primary Taxonomy101YM0800X

Provider Legal NameDIEGO FERNANDO GOMEZCredential: LCAS-A

Location Address15901 BASS RD STE 108Fort Myers, FL 33908

Mailing AddressPo Box 2147Fort Myers, FL 33902-2147 · (239) 343-6050 · Fax (239) 343-6051

Phone(239) 343-6050

Fax(239) 343-6051

Sole ProprietorNo

Enumeration DateJune 16, 2015

Last NPPES UpdateSeptember 3, 20202 updates tracked since enumeration

NPPES CertifiedSeptember 3, 2020

✔ NPI 1275914111 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in FL · MH14194

15901 BASS RD STE 108, Fort Myers, FL 33908

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Secondary Practice Location 1

Location 1229 Turner DrReidsville, NC 27320-5736 · Phone (336) 349-2233

Other Identifiers 1

Medicaid100799300FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Diego Fernando Gomez Lcas-a is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DEEPA VADUTHALAKUZHY LUKA MD

Psychiatry & Neurology (Child & Adolescent Psychiatry)