Fidencio Gonzales, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA03153 Issued in TX

Practice address

14800 San Pedro Ave
Suite 202
San Antonio, TX 78232-3733

Phone

(210) 582-6600

Fax

(210) 582-6601

NPI assigned

Nov 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 3

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, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Quality Acute Care PAGroup PAC ID 2668690538, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Quality Acute Care, PA

  • Urgent Care Clinic/Center
  • Boerne, TX
  • NPI 1255760054
  Medicare reassignment Care Compare group
• Tricity Pain Associates PA

  • Interventional Pain Medicine Physician
  • San Antonio, TX
  • NPI 1619244720
  Medicare reassignment NPD
• Alliance Spine and Pain Management, PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Boerne, TX
  • NPI 1740731074
  Medicare reassignment
• Tricity Pain Associates PA

  • Interventional Pain Medicine Physician
  • San Antonio, TX
  • NPI 1235016486
  NPD
• Consultants in Pain Medicine, PLLC

  • Pain Medicine Physician
  • San Antonio, TX
  • NPI 1538706718
  NPD (past)
• Hill Country Pain Associates, P.a.

  • Pain Medicine Physician
  • San Antonio, TX
  • NPI 1306114533
  NPD (past)

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1821163239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19141 STONE OAK PKWY STE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583367",
            "telephone_number": "210-268-0129",
            "fax_number": "210-311-4609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14800 SAN PEDRO AVE",
            "address_2": "SUITE 202",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782323733",
            "telephone_number": "210-582-6600",
            "fax_number": "210-582-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "FIDENCIO",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA03153",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA03153",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tcpa2@ppdxdirect.com",
            "affiliation": "Y",
            "endpointDescription": "Direct",
            "affiliationName": "Tricity Pain Associates PA",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "14800 San Pedro Ave Ste 115",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782323734",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tcpa2@ppdxdirect.com",
            "affiliation": "Y",
            "endpointDescription": "Direct",
            "affiliationName": "Tricity Pain Associates PA",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1011 S State Highhway 16",
            "address_2": "Suite 5",
            "city": "Fredericksburg",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786244472",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tcpa2@ppdxdirect.com",
            "affiliation": "Y",
            "endpointDescription": "Direct",
            "affiliationName": "Tricity Pain Associates PA",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "861 Landa St",
            "city": "New Braunfels",
            "state": "TX",
            "country_code": "US",
            "postal_code": "781306115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elma Gonzales, M.A. CCC/SLP
• Eneida Marie Gonzales, OTR
• Ernestine Grace Gonzales, R.D.,L.D.,CDE
• Faith Gonzales
• Felicitas S Gonzales, M.D.
• Fred Gonzales, LBSW
• Geneva P Gonzales
• Geoffrey Gonzales
• Geoffrey M Gonzales, PMHNP
• Gilbert Gonzales Jr., D.C.

• Physician Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.