Individual provider Active NPI

Annika Marie Gonzalez, MD

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1780717595
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M6150 Issued in TX
Practice address
3503 Paesanos Pkwy Ste 101
San Antonio, TX 78231-1225
Phone
(210) 492-8922
Fax
(210) 479-2010
NPI assigned
Mar 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M6150 TX Primary

Addresses

Primary practice location

3503 Paesanos Pkwy Ste 101
San Antonio, TX 78231-1225

Mailing address

3503 Paesanos Pkwy Ste 101
San Antonio, TX 78231-1225
Phone (210) 492-8922

Other identifiers 2

IdentifierTypeStateIssuer
1937781-04MedicaidTX
1937781-05OtherTXMEDICAID CSHCN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Feb 7, 2024 through Feb 7, 2028

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Health by Design Medical Group CurrentSince Dec 8, 2024 Accepting new patients

Locations

3503 Paesanos Pkwy
Ste 101
San Antonio, TX 78231
Phone (210) 492-8922

13409 George Rd
San Antonio, TX 78230
Phone (210) 345-4855

Interoperability endpoints

  • Direct secure messaging: annika.gonzalez@546238333255684.direct.elationemr.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1780717595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3503 PAESANOS PKWY STE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782311225",
            "telephone_number": "210-492-8922",
            "fax_number": "210-479-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3503 PAESANOS PKWY STE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782311225",
            "telephone_number": "210-492-8922",
            "fax_number": "210-479-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "ANNIKA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M6150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1937781-04",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID CSHCN",
            "identifier": "1937781-05",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.