Alice Kim Gong, MD

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

G9104 Issued in TX

Practice address

4502 Medical Dr FL 5
San Antonio, TX 78229-4402

Phone

(210) 257-1400

NPI assigned

Aug 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: agong49088@uhssa.direct-ci.com

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.

• Community Medicine Associates

  • Family Medicine Physician
  • San Antonio, TX
  • NPI 1245313329
  Medicare reassignment NPD
• University of Texas Health Science Center at San Antonio

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1720051717
  Medicare reassignment NPD
• The University of Texas Health Science Center at San Antonio

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1326829904
  NPD
• University of Texas Health Science Center at San Antonio

  • Diagnostic Radiology Physician
  • Boerne, TX
  • NPI 1417921834
  NPD
• University of Texas Health Science Center at San Antonio

  • Clinical Pathology/Laboratory Medicine Physician
  • San Antonio, TX
  • NPI 1396717989
  NPD (past)

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184284800000",
    "number": "1114034113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UTHSCSA, UTHSCSA, DEPT. OF PEDIATRICS",
            "address_2": "7703 FLOYD CURL DRIVE, MSC 7812",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293900",
            "telephone_number": "210-358-1593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR FL 5",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-257-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONG",
        "first_name": "ALICE",
        "middle_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "TX",
            "license": "G9104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103027201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valerie S Gomez, MD
• Veronica Gomez, LVN
• Xochitl Gomez, LMT
• Anish Chandra Gonchigar, MD
• Jennifer Jester Gondos, PT
• Richard John Gong, MD
• Edward Gongora
• Camilo Alberto Gonima, M.D.
• Jake Gonta, CTRS
• Michele Gonyer-Russell

• Neonatal-Perinatal Medicine Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Neonatal-Perinatal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.