Jacqueline Gonzalez

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

TEMPORARY Issued in TX

Practice address

3721 Williams Dr
Georgetown, TX 78628-2401

Phone

(512) 869-7310

NPI assigned

Jun 23, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Austin Family Allergy and Asthma, PAGroup PAC ID 9234562059, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Physician Assistant

State licenses

Practice roles

Locations

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

• Austin Family Allergy & Asthma, PA

  • Allergy & Immunology Physician
  • Austin, TX
  • NPI 1578625190
  Medicare reassignment Care Compare group
• Allergy & ENT Associates, PLLC

  • Allergy & Immunology Physician
  • Lake Jackson, TX
  • NPI 1902820368
  Medicare reassignment
• Allergy & ENT Associates PLLC

  • Allergy & Immunology Physician
  • Houston, TX
  • NPI 1568157980
  NPD

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1053980953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3721 WILLIAMS DR",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786282401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3721 WILLIAMS DR",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786282401",
            "telephone_number": "512-869-7310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 University Oaks Ste 1260",
            "address_purpose": "LOCATION",
            "city": "Round Rock",
            "state": "TX",
            "postal_code": "786652437",
            "country_code": "US",
            "telephone_number": "512-537-4191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PATEMP",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "TEMPORARY",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Marie Gonzales, DDS
• Marion Gonzales, RPH
• Michael Gonzales, FNP
• Olivia Danielle Gonzales, BSPH, CHW
• Emily Socorro Gonzalez, PA-C
• Jennifer Joy Gonzalez, MS, OTR
• Lynzy Ann Gonzalez, MA, CCC-SLP
• Lauren T Goodale, FNP-C
• Sheryl Anne Goodman, LPC
• Julie J Goodson

• Surgical Physician Assistant in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.