Individual provider Active NPI

Stephanie Ester Gonzalez, PA-C

  • Physician Assistant
  • Austin, TX
National Provider Identifier
1881158400
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
023200 Issued in NY
Practice address
4900 Mueller Blvd
Austin, TX 78723-3051
Phone
(512) 324-0000
NPI assigned
Jan 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 023200 NY Primary

Addresses

Primary practice location

4900 Mueller Blvd
Austin, TX 78723-3051

Mailing address

104 Peggy CV
Liberty Hill, TX 78642-4453
Phone (845) 499-6264

Other identifiers 1

IdentifierTypeStateIssuer
743608555-00OtherNYFIDELITY CARE

Other names 1

  • Stephanie Ester Katznelson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20190523000906 NY Practitioner - Physician Assistant 9032452651 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Acute Care Surgery Medical Group, Inc. CurrentSince May 30, 2020 Accepting new patients

Locations

70 Dubois St
Newburgh, NY 12550
Phone (845) 534-4673

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.

NPI Registry JSON

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

{
    "created_epoch": "1548633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1881158400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 PEGGY CV",
            "city": "LIBERTY HILL",
            "state": "TX",
            "postal_code": "786424453",
            "telephone_number": "845-499-6264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 MUELLER BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233051",
            "telephone_number": "512-324-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "STEPHANIE",
        "middle_name": "ESTER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-28",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "023200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELITY CARE",
            "identifier": "743608555-00",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "KATZNELSON",
            "middle_name": "ESTER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.