Individual provider Active NPI

Gabriel M Benites, PA-C

  • Physician Assistant
  • Windcrest, TX
National Provider Identifier
1053388819
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01916 Issued in TX
Practice address
5340 Walzem Rd Ste 5340
Windcrest, TX 78218-2123
Phone
(210) 653-8085
Fax
(210) 599-8508
NPI assigned
Mar 1, 2006
Last updated
Sep 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA01916 TX Primary

Addresses

Primary practice location

5340 Walzem Rd Ste 5340
Windcrest, TX 78218-2123

Mailing address

5340 Walzem Rd Ste 5340
Windcrest, TX 78218-2123
Phone (210) 653-8085

Other identifiers 1

IdentifierTypeStateIssuer
309254601MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080122000784 TX Practitioner - Physician Assistant 9032290580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Practice addresses (Care Compare)

517 SW Military Dr
Suite 106
San Antonio, TX 78221-1639
Phone (210) 921-0322

6157 NW Loop 410
124 Wellmed at Ingram Park
San Antonio, TX 78238-3302
Phone (210) 523-1411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, PA CurrentSince Aug 4, 2020 Accepting new patients
Wellmed Medical Group, P.a. CurrentSince Aug 4, 2020 Accepting new patients
Garza Medical Group @ South Alamo PastSince Nov 30, 2020 Accepting new patients

Locations

4203 E Southcross Blvd
San Antonio, TX 78222

600 Division Ave
Ste E
San Antonio, TX 78214
Phone (210) 924-4279

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

5340 Walzem Rd
Ste 5340
Windcrest, TX 78218
Phone (210) 653-8085

Interoperability endpoints

  • Direct secure messaging: gabriel.benites@wellmed.eclinicaldirectplus.com
  • FHIR API: https://api.platform.athenahealth.com/18288/brand/1/csg/1/fhir/r4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1053388819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5340 WALZEM RD STE 5340",
            "city": "WINDCREST",
            "state": "TX",
            "postal_code": "782182123",
            "telephone_number": "210-653-8085",
            "fax_number": "210-599-8508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5340 WALZEM RD STE 5340",
            "city": "WINDCREST",
            "state": "TX",
            "postal_code": "782182123",
            "telephone_number": "210-653-8085",
            "fax_number": "210-599-8508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENITES",
        "first_name": "GABRIEL",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA01916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "309254601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Windcrest, TX

Sources for this page

Verify at the official NPI Registry.