BETH GOMEZ (FNP BC PMHNP BC) – Family Nurse Practitioner, NPI 1609263417

BETH GOMEZ (FNP BC PMHNP BC) is a healthcare provider. based in Urbana, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP BC PMHNP BC. They hold a License No. 209012705 (IL). The NPI Number for BETH GOMEZ (FNP BC PMHNP BC) is 1609263417

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
BETH GOMEZ (FNP BC PMHNP BC)
NPI
1609263417
Phone
(217) 278-8669
Address
301 S VINE ST
Enumeration Date
20 April 2015
Last Update Date
18 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8159413882
Graduation Year
2023 (3 years ago)
PAC ID
1052839909
Group Practice PAC ID
2365858289
Professional Enrollment ID
I20250515000534
Address ID
IL604503107MO1802XSTXX402
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience51
Completeness75
Years active:11State licenses:1Digital endpointsOther names

11,637 NURSE PRACTITIONER in IL

Provider Addresses for BETH GOMEZ (FNP BC PMHNP BC)

  • 301 S VINE ST

    URBANA, IL 618013347

    Phone: (217) 278-8669

    Type: Mailing

  • 200 E Fairman Ave

    Watseka, IL 609701644

    Phone: (815) 432-6175

    Type: Location

  • 301 E LINCOLN AVE

    ONARGA, IL 609551312

    Phone: (815) 268-4413

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $17.

Total Amount is formed as General ($17) + Research ($0) + Ownership ($0) = $17.

Last reported payment date: 2023-12-06 • Largest payer in this snapshot: ITI, Inc. ($17).

Total Amount

$17

General + Research + Ownership

Payments

1

Total payment records

General Amount

$17

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-12-06

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ITI, Inc.$17
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-05-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250515000534INurse PractitionerILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61801)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2365858289View full group profile
NameSpecialtyState
P S Y C H I A T R YIL
Nurse PractitionerIL

Reviews

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Frequently asked questions

What identifier follows BETH GOMEZ (FNP BC PMHNP BC) across health systems?
The NPI 1609263417 uniquely identifies BETH GOMEZ (FNP BC PMHNP BC) in U.S. healthcare data.
Is BETH GOMEZ (FNP BC PMHNP BC) currently accepting referrals based on NPI status?
Registry metadata lists BETH GOMEZ (FNP BC PMHNP BC) as active.
What services align with BETH GOMEZ (FNP BC PMHNP BC)'s listing?
BETH GOMEZ (FNP BC PMHNP BC)'s public classification highlights Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What city is tied to BETH GOMEZ (FNP BC PMHNP BC)?
The directory associates BETH GOMEZ (FNP BC PMHNP BC) with Urbana, Illinois. Check all listed addresses for suites or satellite offices.
Can I export BETH GOMEZ (FNP BC PMHNP BC)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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