KACIE WALLACE GONZALES – Physician Assistant, NPI 1649899600
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,797 PHYSICIAN ASSISTANT in OK
Provider Addresses for KACIE WALLACE GONZALES
800 N OKLAHOMA AVE APT 2207
OKLAHOMA CITY, OK 731044421
Phone: (979) 450-5422
Type: Mailing
800 NE 10TH ST
OKLAHOMA CITY, OK 731045418
Phone: (405) 271-4022
Type: Location
2215 E VILLA MARIA RD STE 110
BRYAN, TX 778022585
Phone: (979) 776-2000
Fax: (866) 733-2572
Type: Mailing
2435 Harvey Mitchell Parkway South
College Station, TX 77845
Phone: (979) 776-2000
Fax: (866) 733-2572
Type: Location
6270 DILLY SHAW TAP RD
BRYAN, TX 778088624
Phone: (979) 450-5422
Type: Mailing
2805 EARL RUDDER FWY S
COLLEGE STATION, TX 778456080
Phone: (979) 764-3090
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 6 Open Payments records for all available years, with a total value of $162.
Total Amount is formed as General ($162) + Research ($0) + Ownership ($0) = $162.
Last reported payment date: 2024-12-12 • Largest payer in this snapshot: GENZYME CORPORATION ($96).
Total Amount
$162
General + Research + Ownership
Payments
6
Total payment records
General Amount
$162
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GENZYME CORPORATION | $96 |
| Medtronic, Inc. | $33 |
| Inspire Medical Systems, Inc. | $32 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-11-02
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20200707002615 | I | Physician Assistant | OK | TBD |
| I20211102001362 | I | Physician Assistant | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 95004 | Test for allergy using allergenic extract | 988 | 13 | $0 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 664 | 39 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 193 | 143 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 167 | 132 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 87 | 87 | $0 |
Insurance plans in this area (ZIP 73104)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Qualified Audiologist | IL | |
| O T O L A R Y N G O L O G Y | TX | |
| Qualified Audiologist | TX | |
| O T O L A R Y N G O L O G Y | TX | |
| Physician Assistant | TX |
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