DR. REYDOMINIQUE LUCERO GUMBOC (MD) – Surgery of the Hand (Surgery) Physician, NPI 1710990403

DR. REYDOMINIQUE LUCERO GUMBOC (MD) is a healthcare provider. based in Salem, Oregon. specializing in ORTHOPEDIC SURGERY. They hold the professional credentials MD. They hold a License No. MDR4859 (HI). The NPI Number for DR. REYDOMINIQUE LUCERO GUMBOC (MD) is 1710990403

Main info

Male
21 Years Of Experience
Accepts Medicare Assignment
Name
DR. REYDOMINIQUE LUCERO GUMBOC (MD)
NPI
1710990403
Phone
Not provided
Address
5125 SKYLINE RD S
Enumeration Date
14 August 2006
Last Update Date
4 February 2022

Doctor Profile

Medical School Name
UNIFORMED SERVICES UHS FE HEBERT SCHOOL OF MED
Secondary Phone
8008132000
Graduation Year
2005 (21 years ago)
PAC ID
5193963940
Group Practice PAC ID
5799688230
Professional Enrollment ID
I20210120003055
Address ID
OR973069427SA5125XSXXX400

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience90
Completeness85
Years active:19State licenses:3Other namesUpdated within 12 months

123 ORTHOPEDIC SURGERY in HI

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Provider Addresses for DR. REYDOMINIQUE LUCERO GUMBOC (MD)

  • 5125 SKYLINE RD S

    SALEM, OR 973069427

    Phone:

    Type: Mailing

  • Kaiamu Street, Kupuna Loop + Kupuohi Street, Royal Kunia, Waipahu, Honolulu County, Hawaii, 96797, United States

    WAIPAHU, HI 967975454

    Phone:

    Type: Mailing

  • 1, Jarrett White Road, Moanalua Gardens, Honolulu, Honolulu County, Hawaii, 96859, United States

    TRIPLER AMC, DEPT OF ORTHOPAEDIC SURGERY

    HONOLULU, HI 96589

    Phone: (808) 433-3557

    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: 2021-01-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20190911000513IOrthopedic SurgeryWATBD
I20210120003055IOrthopedic SurgeryORTBD

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 97306)

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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: 5799688230View full group profile
NameSpecialtyState
U R O L O G YTX
Emergency MedicineOR
D E R M A T O L O G YAZ
Nurse PractitionerOR
Diagnostic RadiologyOR
D E R M A T O L O G YWA
-OR
-CA
General SurgeryCA
-OR

Reviews

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Frequently asked questions

Can I use this page to confirm DR. REYDOMINIQUE LUCERO GUMBOC (MD)'s NPI?
Yes. DR. REYDOMINIQUE LUCERO GUMBOC (MD) is listed with NPI 1710990403 in the public NPI dataset.
Is DR. REYDOMINIQUE LUCERO GUMBOC (MD) listed as active for patients and plans?
The listing shows DR. REYDOMINIQUE LUCERO GUMBOC (MD) as active in the NPI system.
What is DR. REYDOMINIQUE LUCERO GUMBOC (MD) best known for clinically?
Directory data describes DR. REYDOMINIQUE LUCERO GUMBOC (MD) with Surgery of the Hand (Surgery) Physician. Clinical services aligned with this taxonomy classification.
What address line appears for DR. REYDOMINIQUE LUCERO GUMBOC (MD)?
DR. REYDOMINIQUE LUCERO GUMBOC (MD)'s geographic hint is Salem, Oregon in our summary view.
Is the information about DR. REYDOMINIQUE LUCERO GUMBOC (MD) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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