Individual provider Active NPI

Daniel Tamez Gonzalez, PA

  • Physician Assistant
  • Edinburg, TX
National Provider Identifier
1104243807
Registry record updated Nov 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA08951 Issued in TX
Practice address
2717 Michaelangelo Dr Ste 200
Edinburg, TX 78539-1412
Phone
(956) 362-3780
Fax
(956) 362-3793
NPI assigned
Mar 20, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2020

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 PA08951 TX Primary

Addresses

Primary practice location

2717 Michaelangelo Dr Ste 200
Edinburg, TX 78539-1412

Mailing address

PO Box 749
Pharr, TX 78577-1614
Phone (956) 362-3780

Other identifiers 3

IdentifierTypeStateIssuer
343108YLPSOtherTXWELLMED PTAN
337880401MedicaidTX
337880402MedicaidTX

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
I20140506002145 TX Practitioner - Physician Assistant 6608009212 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jose E Igoa MD PAGroup PAC ID 0547323016, 5 clinicians

Practice addresses (Care Compare)

3600 N 23Rd St
Suite 103
McAllen, TX 78501-6081
Phone (956) 682-4401

Merit-based Incentive Payment System (MIPS)

Final score
98.1 of 100Reported as group
Quality
86
Improvement activities
40

National Provider Directory

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

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
DHR Health HospiceEdinburg, TX, CCN 671788 Hospice Corporate Officer
Corporate Director
Aug 14, 2020
Aug 14, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

NPI Registry JSON

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

{
    "created_epoch": "1395273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1104243807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "785771614",
            "telephone_number": "956-362-3780",
            "fax_number": "956-362-3793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2717 MICHAELANGELO DR STE 200",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785391412",
            "telephone_number": "956-362-3780",
            "fax_number": "956-362-3793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMEZ GONZALEZ",
        "first_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-20",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA08951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED PTAN",
            "identifier": "343108YLPS",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "337880401",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "337880402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinburg, TX

Sources for this page

Verify at the official NPI Registry.