MISTY GOMEZ – Counselor, NPI 1881109429

MISTY GOMEZ is a healthcare provider. based in Bryan, Ohio. specializing in CLINICAL SOCIAL WORKER. The NPI Number for MISTY GOMEZ is 1881109429

Main info

Female
Sole Proprietor
4 Years Of Experience
Accepts Medicare Assignment
Name
MISTY GOMEZ
NPI
1881109429
Phone
(419) 576-6624
Address
403 OAKWOOD AVE APT D
Enumeration Date
5 December 2017
Last Update Date
5 December 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4197853800
Graduation Year
2022 (4 years ago)
PAC ID
6709303175
Group Practice PAC ID
0547293003
Professional Enrollment ID
I20250508002303
Address ID
OH435122408DE211XXAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience21
Completeness75
Years active:8State licenses:0Digital endpointsOther names

2,650 CLINICAL SOCIAL WORKER in OH

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Provider Addresses for MISTY GOMEZ

  • 403 OAKWOOD AVE APT D

    BRYAN, OH 435061629

    Phone: (419) 576-6624

    Type: Mailing

  • 211, Biede Avenue, Defiance, Defiance County, Ohio, 43512, United States

    DEFIANCE, OH 435122408

    Phone: (419) 782-8856

    Fax: (419) 784-4506

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2025-05-08

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
I20250508002303IClinical Social WorkerOHTBD

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 43506)

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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: 0547293003View full group profile
NameSpecialtyState
Mental Health CounselorOH
Mental Health CounselorOH
-OH
Clinical Social WorkerOH
Clinical Social WorkerOH

Reviews

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Frequently asked questions

Can I use this page to confirm MISTY GOMEZ's NPI?
Yes. MISTY GOMEZ is listed with NPI 1881109429 in the public NPI dataset.
Can I rely on MISTY GOMEZ being an active provider?
As of the registry snapshot, MISTY GOMEZ is marked active.
What is MISTY GOMEZ best known for clinically?
Directory data describes MISTY GOMEZ with Counselor. Clinical services aligned with this taxonomy classification.
Where should I expect MISTY GOMEZ on a map?
Expect Bryan, Ohio as a primary anchor for MISTY GOMEZ unless the record lists multiple sites.
Is the information about MISTY GOMEZ up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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