Individual provider Active NPI

Annette Carey Gonsalves, MD

  • Internal Medicine Physician
  • Waldorf, MD
National Provider Identifier
1306910716
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D19947 Issued in MD
Practice address
6 Post Office Rd
Suite 100
Waldorf, MD 20602-2746
Phone
(301) 645-4994
Fax
(301) 645-0041
NPI assigned
Nov 17, 2006
Last updated
Dec 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D19947 MD Primary

Addresses

Primary practice location

6 Post Office Rd
Suite 100
Waldorf, MD 20602-2746

Mailing address

6 Post Office Rd
Suite 100
Waldorf, MD 20602-2746
Phone (301) 645-4994

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080409000412 MD Practitioner - Internal Medicine 9931286309 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6 Post Office Rd
Suite 100
Waldorf, MD 20602-2746
Phone (301) 645-4994

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D19947MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: annette.gonsalves@annettegonsalvesmd.chartmakerdirect.com

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

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1306910716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 POST OFFICE RD",
            "address_2": "SUITE 100",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022746",
            "telephone_number": "301-645-4994",
            "fax_number": "301-645-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 POST OFFICE RD",
            "address_2": "SUITE 100",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022746",
            "telephone_number": "301-645-4994",
            "fax_number": "301-645-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONSALVES",
        "first_name": "ANNETTE",
        "middle_name": "CAREY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D19947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

Verify at the official NPI Registry.