Individual provider Active NPI

Joannah Marie Gonzales, PA - C

  • Surgical Physician Assistant
  • Houston, TX
National Provider Identifier
1285721829
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA04665 Issued in TX
Practice address
6414 Fannin St Ste G150
Houston, TX 77030-1514
Phone
(713) 486-7560
Fax
(713) 486-7512
NPI assigned
Oct 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA04665 TX Primary

Addresses

Primary practice location

6414 Fannin St Ste G150
Houston, TX 77030-1514

Mailing address

6400 Fannin St Ste 1700
Houston, TX 77030-1526
Phone (713) 486-7560

Other identifiers 1

IdentifierTypeStateIssuer
320413OtherTXGRP PTAN QSS TEXAS

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
I20090619000128 TX Practitioner - Physician Assistant 4385795004 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut PhysiciansGroup PAC ID 8426960360, 1,744 clinicians

Practice addresses (Care Compare)

6410 Fannin St
Houston, TX 77030-3005

6411 Fannin St
Houston, TX 77030-1501
Phone (713) 704-0093

6414 Fannin St
Suite G125
Houston, TX 77030-1517

6431 Fannin St
MSB2.100
Houston, TX 77030-1501
Phone (713) 500-7700

Hospital & facility affiliations

  • Memorial Hermann - Texas Medical Center Hospital, Houston, TX, CCN 450068

Merit-based Incentive Payment System (MIPS)

Final score
84.11 of 100Reported as group
Quality
69.15
Promoting interoperability
100
Improvement activities
40
Cost
73.63

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Jan 23, 2019 Accepting new patients
Ut Physicians CurrentSince Jan 23, 2019 Accepting new patients
Qualified Surgical Services PLLC Past Accepting new patients
QSS-Southeast Clinical Services LLC Past Accepting new patients

Locations

6400 Fannin St
Ste 1700
Houston, TX 77030
Phone (713) 486-5527

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

6414 Fannin St
Ste G150
Houston, TX 77030
Phone (713) 486-7560

12121 Richmond Ave
Ste 120
Houston, TX 77082
Phone (281) 569-4647

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1285721829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 FANNIN ST STE 1700",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301526",
            "telephone_number": "713-486-7560",
            "fax_number": "713-486-7512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6414 FANNIN ST STE G150",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301514",
            "telephone_number": "713-486-7560",
            "fax_number": "713-486-7512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "JOANNAH",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA - C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2022-08-23",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA04665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GRP PTAN QSS TEXAS",
            "identifier": "320413",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.