Dalyssa Renee Gonzalez, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

10013TG Issued in TX

Practice address

24165 Ih 10 W Ste 125
San Antonio, TX 78257-1160

Phone

(210) 698-2020

Fax

(210) 698-7886

NPI assigned

Jul 6, 2020

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

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rachel Duran Tellez OD PAGroup PAC ID 6103991583, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Rachel Duran Tellez OD PA

  • Optometrist
  • San Antonio, TX
  • NPI 1962422774
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1336767466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24165 IH 10 W STE 125",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782571160",
            "telephone_number": "210-698-2020",
            "fax_number": "210-698-7886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24165 IH 10 W STE 125",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782571160",
            "telephone_number": "210-698-2020",
            "fax_number": "210-698-7886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "DALYSSA",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-06",
        "last_updated": "2020-12-29",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10013TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Gonzalez
• Clarissa Gonzalez
• Cleo G Gonzalez, MASSAGE THERAPIST
• Cristhian Gonzalez, IOM
• Daena Gonzalez
• Danielle Celene Gonzalez
• David Gonzalez, M.D.
• David M Gonzalez, M.D.
• David V. Gonzalez
• Deandra Christina Gonzalez, M.D.

• Optometrist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; 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.
• 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.