NPIMap

Individual provider Active NPI

Stephanie Rebecca Gonsalves, PA-C

  • Physician Assistant
  • York, ME
National Provider Identifier
1144732058
Registry record updated Nov 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1756 Issued in ME
Practice address
15 Hospital Dr
York, ME 03909-1011
Phone
(207) 363-4321
NPI assigned
Nov 1, 2017
Last updated
Nov 1, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2017

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 PA1756 ME Primary

Addresses

Primary practice location

15 Hospital Dr
York, ME 03909-1011

Mailing address

97B Old Dennett Rd
Kittery, ME 03904-1058
Phone (857) 277-4195

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180112001516 ME Practitioner - Physician Assistant 3971862293 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
York HospitalGroup PAC ID 6406766781, 202 clinicians

Practice addresses (Care Compare)

112 Sanford Rd
Wells, ME 04090-5533

114 Sanford Rd
Myhealth Wells
Wells, ME 04090-5533
Phone (207) 646-5211

15 Hospital Dr
York, ME 03909-1011
Phone (207) 363-4321

16 Hospital Dr
York, ME 03909-1011
Phone (207) 351-3715

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA1756MEMDPhysician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 37

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1509494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509494400000",
    "number": "1144732058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97B OLD DENNETT RD",
            "city": "KITTERY",
            "state": "ME",
            "postal_code": "039041058",
            "telephone_number": "857-277-4195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 HOSPITAL DR",
            "city": "YORK",
            "state": "ME",
            "postal_code": "039091011",
            "telephone_number": "207-363-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONSALVES",
        "first_name": "STEPHANIE",
        "middle_name": "REBECCA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-01",
        "last_updated": "2017-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA1756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in York, ME

Sources for this page

Verify at the official NPI Registry.