Individual provider Active NPI

John J Gonzalez Jr., M.D.

  • Surgery Physician
  • San Antonio, TX
National Provider Identifier
1700857927
Registry record updated Feb 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
L2284 Issued in TX
Practice address
8811 Village Dr
Suite 300
San Antonio, TX 78217-5415
Phone
(210) 651-0303
Fax
(210) 651-0302
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X L2284 TX Primary

Addresses

Primary practice location

8811 Village Dr
Suite 300
San Antonio, TX 78217-5415

Mailing address

PO Box 928
San Antonio, TX 78294-0928
Phone (210) 651-0303

Other identifiers 1

IdentifierTypeStateIssuer
085170101MedicaidTX

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050922000543 TX Practitioner - General Surgery 8224062963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Missouri, Columbia School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Center for Medical and Surgical Weight Loss P aGroup PAC ID 7517990120, 11 clinicians

Practice addresses (Care Compare)

9618 Huebner Rd
Suite 202
San Antonio, TX 78240-1776
Phone 2106510303226

Hospital & facility affiliations

  • Baptist Medical Center Hospital, San Antonio, TX, CCN 450058
  • Foundation Surgical Hospital of San Antonio Hospital, San Antonio, TX, CCN 670054
  • Westover Hills Baptist Hospital Hospital, San Antonio, TX, CCN 670333

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux17
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Surgical Associates, P.a. Surgery CurrentSince Jul 1, 2005 Accepting new patients

Locations

8019 S New Braunfels
Ste 115
San Antonio, TX 78235
Phone (210) 333-7510

4242 E Southcross Blvd
Ste 1
San Antonio, TX 78222
Phone (210) 333-7510

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19317/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329955200000",
    "number": "1700857927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 928",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782940928",
            "telephone_number": "210-651-0303",
            "fax_number": "210-651-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8811 VILLAGE DR",
            "address_2": "SUITE 300",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175415",
            "telephone_number": "210-651-0303",
            "fax_number": "210-651-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2012-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "L2284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085170101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.