CARMEN E GOTA MD
NPI 1568427052
Internal Medicine - Rheumatology in St. George, UT

Active since April 19, 2006PECOS EnrolledAccepts Medicare Assignment
81.83/100
CMS Quality Rating
1060 SOUTH MAIN STREET, BLDG A, STE 102B, ST. GEORGE, UT 84770(435) 292-6492(434) 355-3950 Get Directions Write a Review

NPPES record last updated: February 24, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 24, 2025, Dec 11, 2024, Dec 6, 2024 and 2 more (5 updates tracked since 2022).

About Carmen E Gota Md NPPES

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

CARMEN E GOTA MD (NPI 1568427052) is an individual rheumatology provider in St. George, Utah, licensed in Utah (12719806-1205) and active in the NPI registry since April 2006. She is enrolled in Medicare PECOS, is affiliated with St James Healthcare, and is a graduate of Other (1989).

NPPES Registry Identity

NPI1568427052
Entity TypeIndividualFemale
Primary Taxonomy207RR0500X
Provider Legal NameCARMEN E GOTACredential: MD
Location Address1060 SOUTH MAIN STREET, BLDG A, STE 102BSt. George, UT 84770-5260
Mailing Address1060 South Main Street, Bldg A, Ste 102bSt. George, UT 84770-5260 · (435) 292-6492 · Fax (434) 355-3950
Fax(434) 355-3950
Sole ProprietorNo
Medical School CMSOtherGraduated 1989
Enumeration DateApril 19, 2006
Last NPPES UpdateFebruary 24, 20255 updates tracked since enumeration
NPPES CertifiedFebruary 24, 2025
NPI 1568427052 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · RheumatologyAllopathic & Osteopathic Physicians
Taxonomy Code207RR0500X
Licenses Licensed in UT · 12719806-1205 Licensed in MN · 76241 Licensed in OH · 35082592
Definition
An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.
1060 SOUTH MAIN STREET, St. George, UT 84770

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Carmen E Gota Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9537147434
PECOS Enrollment IDI20220330000564, I20260413000200
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.

Areas of Expertise CMS Part B claims 14

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) J0717
Certolizumab pegol is a medication injected under a doctor's supervision. It's used to treat certain inflammatory conditions like rheumatoid arthritis. The injection helps reduce symptoms like pain and swelling. Note that this drug isn't for self-administration.
36,000 services47 patients
Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) J0129
Abatacept is a medication administered via injection under a doctor's supervision. It's used to treat conditions like rheumatoid arthritis by moderating the immune system. This code applies when the doctor administers the drug, not for self-administration.
1,325 services13 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
496 services369 patients
Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle 96401
This procedure involves giving anti-cancer drugs, which don't contain hormones, into the muscle or under the skin. These drugs help to stop the growth of cancer cells. The process is usually quick and done by a healthcare professional.
180 services47 patients
Measurement c-reactive protein for detection of infection or inflammation 86140
C-reactive protein (CRP) test is a blood test that checks for signs of inflammation or infection in the body. High levels of CRP often suggest that there's inflammation or a bacterial infection. This test helps in monitoring and managing conditions like arthritis and heart disease.
57 services51 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
56 services50 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St James Healthcare

Acute Care Hospitals · Butte, MT
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number270017
Location400 S Clark StButte, MT 59701 · Silver Bow County
Emergency services Birthing friendly

Community Hospital Of Anaconda

Critical Access Hospitals · Anaconda, MT
OwnershipVoluntary non-profit - Private
CMS Certification Number271335
Location401 W PennsylvaniaAnaconda, MT 59711 · Deer Lodge County
Emergency services Birthing friendly

Cedar City Hospital

Acute Care Hospitals · Cedar City, UT
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number460007
Location1303 North Main StreetCedar City, UT 84721 · Iron County
Emergency services Birthing friendly

St. George Regional Hospital

Acute Care Hospitals · St George, UT
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number460021
Location1380 East Medical Center DriveSt George, UT 84790 · Washington County
Emergency services Birthing friendly

Garfield Memorial Hospital

Critical Access Hospitals · Panguitch, UT
OwnershipVoluntary non-profit - Other
CMS Certification Number461333
Location200 North 400 EastPanguitch, UT 84759 · Garfield County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84770 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$125.70 typical visit price
range $54.34 – $166.03
Typical copayment $31.42 (range $13.58 – $41.50)
Most-billed visit code 99204
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

81.83/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality81.07
Promoting Interoperability100
Improvement Activities40
Cost58.38

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carmen Gota's NPI number?

The NPI number for Carmen Gota is 1568427052. It was assigned to this individual provider in the NPPES registry on April 19, 2006.

Where is Carmen Gota located?

Carmen Gota practices at 1060 South Main Street Bldg A, Ste 102B, St. George, UT 84770. The listed phone number is (435) 292-6492.

What is Carmen Gota's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Is Carmen Gota enrolled in Medicare?

Yes. Carmen Gota is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Carmen Gota accept?

Health plans from Medica, Molina Healthcare, Sanford Health Plan, Select Health and University of Utah Health Plans list Carmen Gota as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Carmen Gota affiliated with any hospitals?

According to CMS data, Carmen Gota is affiliated with St James Healthcare, Community Hospital Of Anaconda, Cedar City Hospital, St. George Regional Hospital and Garfield Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Carmen Gota was last updated on February 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.