Individual provider Active NPI

Stephen Gonzales, MSN,APRN,AGACNP-BC

  • Gerontology Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1558135566
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
1141287 Issued in TX
Practice address
19114 US Highway 281 N
San Antonio, TX 78258-4988
Phone
(210) 496-7999
Fax
(210) 494-1666
NPI assigned
Nov 9, 2023
Last updated
Jan 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1141287 TX
Gerontology Nurse Practitioner 363LG0600X 1141287 TX Primary

Addresses

Primary practice location

19114 US Highway 281 N
San Antonio, TX 78258-4988

Mailing address

19114 US Highway 281 N
San Antonio, TX 78258-4988
Phone (210) 496-7999

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
I20241119000366 TX Practitioner - Nurse Practitioner 1850826579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Practice addresses (Care Compare)

19114 N US Hwy 281
Wellmed at Stone Oak
San Antonio, TX 78258
Phone (210) 496-7999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, PA CurrentSince Nov 18, 2024 Accepting new patients
Wellmed Medical Group, P.a. CurrentSince Nov 18, 2024 Accepting new patients

Locations

19114 US Highway 281 N
San Antonio, TX 78258
Phone (210) 496-7999

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

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, 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": "1699488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1558135566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19114 US HIGHWAY 281 N",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584988",
            "telephone_number": "210-496-7999",
            "fax_number": "210-494-1666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19114 US HIGHWAY 281 N",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584988",
            "telephone_number": "210-496-7999",
            "fax_number": "210-494-1666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "STEPHEN",
        "name_prefix": "Mr.",
        "credential": "MSN,APRN,AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-09",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1141287",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "1141287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.