Individual provider Active NPI

Gabriel Onesimo Avalos, DPT

  • Physical Therapist
  • San Antonio, TX
National Provider Identifier
1194373159
Registry record updated Sep 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1323424 Issued in TX
Practice address
1123 N Main Ave Ste 211
San Antonio, TX 78212-4738
Phone
(210) 226-2101
NPI assigned
Sep 3, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1323424 TX Primary

Addresses

Primary practice location

1123 N Main Ave Ste 211
San Antonio, TX 78212-4738

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190925001168 TX Practitioner - Physical Therapist in Private Practice 0345570966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ideal Physical Therapy of Texas LLCGroup PAC ID 0547583809, 359 clinicians

Practice addresses (Care Compare)

1123 N Main Ave
Suite 211
San Antonio, TX 78212-4738
Phone (210) 226-2101

Merit-based Incentive Payment System (MIPS)

Final score
85.56 of 100Reported as group
Quality
89.48
Improvement activities
40
Cost
71.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Physical Therapy of Texas LLC CurrentSince Sep 9, 2019 Accepting new patients
Ideal Physical Therapy of Texas LLC Physical Therapist CurrentSince Sep 9, 2019 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

17051 Dallas Pkwy
Ste 450
Addison, TX 75001
Phone (214) 272-8561

524 Singing Oaks
Ste 210
Bulverde, TX 78070
Phone (830) 256-7578

4100 Fairway Dr
Ste 400
Carrollton, TX 75010
Phone (972) 394-3325

21918 US Highway 281 N
Ste 105
San Antonio, TX 78258
Phone (210) 580-5857

1123 N Main Ave
Ste 211
San Antonio, TX 78212
Phone (210) 226-2101

3903 Wiseman Blvd
Ste 311
San Antonio, TX 78251
Phone (210) 593-0578

17026 Bulverde Rd
Ste 108
San Antonio, TX 78247
Phone (210) 819-2994

8910 Bandera Rd
Ste 112
San Antonio, TX 78250
Phone (210) 318-3979

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": "1567468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1194373159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1123 N MAIN AVE STE 211",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124738",
            "telephone_number": "210-226-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVALOS",
        "first_name": "GABRIEL",
        "middle_name": "ONESIMO",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-03",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1323424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; 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.

Verify at the official NPI Registry.