Active NPI
William Gonzaba III, DPT
- Physical Therapist
- New Orleans, LA
National Provider Identifier
1063898872
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1261702
- Practice address
- 2525 Jena St
New Orleans, LA 70115-6322 - Phone
- (504) 733-0254
- NPI assigned
- Aug 4, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1261702 | TX | Primary |
Addresses
Primary practice location
2525 Jena St
New Orleans, LA 70115-6322
Mailing address
5606 Jefferson Hwy
Harahan, LA 70123-5111
Phone (504) 733-0254
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
810 Pleasanton Rd
San Antonio, TX 78214-1308
Phone (210) 921-3800
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Magnolia Physical Therapy, LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Gonzaba Medical Group
- Family Medicine Physician
- San Antonio, TX
- NPI 1023030160
-
- Physical Therapist
- Harahan, LA
- NPI 1316083447
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467158400000",
"number": "1063898872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5606 JEFFERSON HWY",
"city": "HARAHAN",
"state": "LA",
"postal_code": "701235111",
"telephone_number": "504-733-0254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 JENA ST",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701156322",
"telephone_number": "504-733-0254"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZABA",
"first_name": "WILLIAM",
"name_suffix": "III",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-08-04",
"last_updated": "2016-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1261702",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New Orleans, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.