Mary Goncalo, RN, MS, CS

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

197997 Issued in MA

Practice address

101 Sullivan Dr
Fall River, MA 02721-6812

Phone

(774) 644-5629

Fax

(508) 678-8100

NPI assigned

Oct 3, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in MA

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

Certified Clinical Nurse Specialist (CNS)

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Master of Science, Registered Nurse

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.

• Mary Goncalo Group Practice

  • Health Psychologist
  • Fall River, MA
  • NPI 1356890164
  NPD (past) Authorized official
• American Help Centers, Inc.

  • Clinical Social Worker
  • Fall River, MA
  • NPI 1447306626
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1316032774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 365",
            "city": "SOMERSET",
            "state": "MA",
            "postal_code": "027260365",
            "telephone_number": "774-644-5629",
            "fax_number": "508-678-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SULLIVAN DR",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027216812",
            "telephone_number": "774-644-5629",
            "fax_number": "508-678-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONCALO",
        "first_name": "MARY",
        "credential": "RN, MS, CS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MA",
            "license": "197997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "410198-001",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE CHIELD",
            "identifier": "PN0790",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOSTON MEDICAL HEALTHNET",
            "identifier": "000000024517",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHP",
            "identifier": "103300",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11089087A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "60054",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1894480",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF  RI",
            "identifier": "214375",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "585968000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raeshaun Janee Gomes
• Taisha S Gomes
• Kiana Marie Gomez
• Samantha A Gomez, LPN
• Jennifer Brandy Gomula, LCSW
• Derek Goncalves
• Bridget Lynn Gonneville, LICSW
• Chad A Gonsalves, P.T.
• Stacy A Gonsalves
• William T Gonsalves

• Psychiatric/Mental Health Registered Nurse in Fall River, MA
• Providers in Fall River, MA by specialty
• Psychiatric/Mental Health Registered Nurse in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.