Individual provider Active NPI

Gabriel David Alonso, APRN

  • Adult Health Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1659981066
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP145697 Issued in TX
Practice address
12554 Hillside RNCH
San Antonio, TX 78254-6266
Phone
(210) 516-2655
Fax
(855) 217-1776
NPI assigned
Aug 1, 2020
Last updated
Jan 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP145697 TX Primary

Addresses

Primary practice location

12554 Hillside RNCH
San Antonio, TX 78254-6266

Mailing address

12554 Hillside RNCH
San Antonio, TX 78254-6266
Phone (210) 516-2655

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
I20221205002047 TX Practitioner - Nurse Practitioner 0547639031 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

414 Babcock Rd
San Antonio, TX 78201-3120
Phone (210) 997-3355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Wound Healing & Dermatology CurrentSince Oct 1, 2022 Accepting new patients
Integrity Wound Care LLC CurrentSince Feb 6, 2024 Accepting new patients

Locations

21137 State Route 410 E
Ste I
Bonney Lake, WA 98391
Phone (253) 862-5275

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ez_00164
  • FHIR API: https://app.meldrx.com/api/fhir/ez_00377

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": "1596240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1659981066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12554 HILLSIDE RNCH",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782546266",
            "telephone_number": "210-516-2655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12554 HILLSIDE RNCH",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782546266",
            "telephone_number": "210-516-2655",
            "fax_number": "855-217-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALONSO",
        "first_name": "GABRIEL",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-01",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP145697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.