Michelle Renae Gonzaba

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R9966 Issued in TX

Practice address

926 Brooklyn Ave
San Antonio, TX 78215-1637

Phone

(201) 229-9282

Fax

(210) 229-9283

NPI assigned

Apr 17, 2016

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

Other names 1

• Michelle Van Hecke Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Texas Medical School at San Antonio, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

GMG Health Systems Associates PAGroup PAC ID 8123932647, 115 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• GMG Health Systems Associates PA

  • Family Medicine Physician
  • San Antonio, TX
  • NPI 1023030160
  Medicare reassignment Care Compare group NPD
• BHS Specialty Network Inc

  • Cardiovascular Disease Physician
  • San Antonio, TX
  • NPI 1831492651
  NPD (past)
• Wellmed Medical Group, PA

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1437156486

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1460851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1700230604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8711 VILLAGE DR STE 114",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175419",
            "telephone_number": "210-229-9282",
            "fax_number": "210-229-9283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 BROOKLYN AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782151637",
            "telephone_number": "201-229-9282",
            "fax_number": "210-229-9283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZABA",
        "first_name": "MICHELLE",
        "middle_name": "RENAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-17",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R9966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "VAN HECKE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jake Gonta, CTRS
• Michele Gonyer-Russell
• Andrew Michael Gonzaba, MD
• Anna Pantusa Gonzaba, M.D.
• Gillian Gabrielle Gonzaba, APRN, NNP
• Vincent Gregory Gonzaba, MD
• William Gonzaba Sr., MD
• William Thomas Gonzaba, M.D.
• Gonzales & Roman, P.a.
• Arlana Gonzales Hernandez

• Family Medicine Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; 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.