Individual provider Active NPI

Gerald Vicent O'Gorman, MD

  • Anesthesiology Physician
  • San Antonio, TX
National Provider Identifier
1548217581
Registry record updated Dec 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
F1866 Issued in TX
Practice address
45 NE Loop 410
Suite 900
San Antonio, TX 78216-5832
Phone
(210) 375-7790
NPI assigned
May 27, 2006
Last updated
Dec 18, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X F1866 TX Primary

Addresses

Primary practice location

45 NE Loop 410
Suite 900
San Antonio, TX 78216-5832

Mailing address

45 NE Loop 410
Suite 900
San Antonio, TX 78216-5832
Phone (210) 375-7790

Other identifiers 1

IdentifierTypeStateIssuer
1204125-05MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Anesthesiology Sa, P.a. Anesthesiology Past Accepting new patients
Tejas Anesthesia PLLC Anesthesiology Past Accepting new patients
Tejas Anesthesia PLLC Anesthesiology PastSince Mar 1, 2022 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418860800000",
    "number": "1548217581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 NE LOOP 410",
            "address_2": "SUITE 900",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782165832",
            "telephone_number": "210-375-7790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 NE LOOP 410",
            "address_2": "SUITE 900",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782165832",
            "telephone_number": "210-375-7790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'GORMAN",
        "first_name": "GERALD",
        "middle_name": "VICENT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2014-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "F1866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1204125-05",
            "state": "TX"
        }
    ],
    "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 Dec 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.