Individual provider Active NPI

Kevin Albert Gonzalez, DPT

  • Physical Therapist
  • San Antonio, TX
National Provider Identifier
1205547833
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1371126 Issued in TX
Practice address
4553 N Loop 1604 W Ste 1115
San Antonio, TX 78249-1364
Phone
(210) 756-5556
Fax
(210) 756-5556
NPI assigned
Dec 5, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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 1371126 TX Primary

Addresses

Primary practice location

4553 N Loop 1604 W Ste 1115
San Antonio, TX 78249-1364

Mailing address

4553 N Loop 1604 W Ste 1115
San Antonio, TX 78249-1364
Phone (210) 756-5556

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230117000283 TX Practitioner - Physical Therapist in Private Practice 6406227198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Movement State PLLCGroup PAC ID 3577925122, 3 clinicians

Practice addresses (Care Compare)

4553 N Loop 1604
Suite 1115
San Antonio, TX 78249-1364
Phone (361) 815-1579

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1371126TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Movement State PLLC Physical Therapist CurrentSince May 15, 2023 Accepting new patients

Locations

4553 N Loop 1604 W
Ste 1115
San Antonio, TX 78249
Phone (210) 756-5556

Organizations & group practices 1

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": "1670198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1205547833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4553 N LOOP 1604 W STE 1115",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782491364",
            "telephone_number": "210-756-5556",
            "fax_number": "210-756-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4553 N LOOP 1604 W STE 1115",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782491364",
            "telephone_number": "210-756-5556",
            "fax_number": "210-756-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "KEVIN",
        "middle_name": "ALBERT",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-05",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1371126",
            "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 Nov 25, 2025; 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.