Lacy Nicole Gonzalez, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

17756 Katy Fwy Ste G1
Houston, TX 77094-1380

Phone

(832) 772-3330

Fax

(832) 772-3332

NPI assigned

Oct 17, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Lacy Nicole Babey 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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clear Dermatology PLLCGroup PAC ID 0345403663, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Clear Dermatology PLLC

  • Dermatology Physician
  • Houston, TX
  • NPI 1467726281

  TX

  Medicare reassignment Care Compare group
• Flatirons Family Practice Inc

  • Family Medicine Physician
  • Broomfield, CO
  • NPI 1609802982
  NPD (past)

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

{
    "created_epoch": "1381968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1841628443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17756 KATY FWY STE G1",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770941380",
            "telephone_number": "832-772-3330",
            "fax_number": "832-772-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17756 KATY FWY STE G1",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770941380",
            "telephone_number": "832-772-3330",
            "fax_number": "832-772-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "LACY",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-17",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "PA09848",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LACY",
            "last_name": "BABEY",
            "middle_name": "NICOLE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Karen Gonzalez
• Karina Gonzalez, NP
• Katherine Gonzalez, RN
• Kathleen R Gonzalez, CNA
• Kendra Gonzalez
• Laura Patricia Gonzalez, CRNA
• Lauren Alyse Gonzalez, BCBA
• Leslie Claire Gonzalez, DPT
• Leslie Jade Gonzalez, CST, CSA, LSA
• Lilia Gonzalez, MSN, FNP - C

• All providers in Houston, TX
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; 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.