Mia Delagarza Gonzalez, PA -C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA04897 Issued in TX

Practice address

2764 Pharmacy Rd
Rio Grande City, TX 78582-6201

Phone

(956) 317-1601

Fax

(956) 317-1603

NPI assigned

Nov 15, 2007

Last updated

Apr 8, 2016By the provider in NPPES

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

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

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oasis Dermatology Group, PLLCGroup PAC ID 5890703508, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Oasis Dermatology Group, PLLC

  dba Dermatology Clinic of McAllen

  • Dermatology Physician
  • McAllen, TX
  • NPI 1619099124
  Medicare reassignment Care Compare group
• Oasis Dermatology Starr County PLLC

  dba Dermatology Clinic of Starr County

  • Dermatology Physician
  • Rio Grande City, TX
  • NPI 1093122723
  NPD (past)

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460073600000",
    "number": "1730360066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 BUDDY OWENS AVE",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785046464",
            "telephone_number": "956-971-0404",
            "fax_number": "956-971-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2764 PHARMACY RD",
            "city": "RIO GRANDE CITY",
            "state": "TX",
            "postal_code": "785826201",
            "telephone_number": "956-317-1601",
            "fax_number": "956-317-1603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MIA",
        "middle_name": "DELAGARZA",
        "credential": "PA -C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-15",
        "last_updated": "2016-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dayna Juliette Gonzalez
• Ivet Gonzalez
• Jessica Gonzalez, COTA
• Jessica R Gonzalez, SLP-CCC
• Kenia Elizabeth Gonzalez
• Palmira Gonzalez, M.ED., LPC
• Yolanda Elena Gonzalez, PA
• Anil Gottimukkala, RPH
• Grace PHC Service LLC
• Myrna Domansi Grajo, FNP

• Physician Assistant in Rio Grande City, TX
• Providers in Rio Grande City, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2016; 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.