Abigail Gonsalves

Primary specialty

OptometristTaxonomy code 152W00000X

License

046.011398 Issued in IL

Practice address

1613 E 55TH St
Chicago, IL 60615-6151

Phone

(312) 363-0202

Fax

(312) 363-0201

NPI assigned

Aug 30, 2019

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 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Village Eye Care LTDGroup PAC ID 2567565088, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Village Eye Care LTD

  • Optometrist
  • Chicago, IL
  • NPI 1477601664
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1567123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1376191445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074455",
            "telephone_number": "312-829-6173",
            "fax_number": "312-663-4270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1613 E 55TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606156151",
            "telephone_number": "312-363-0202",
            "fax_number": "312-363-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONSALVES",
        "first_name": "ABIGAIL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-30",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.011398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS OPTOMETRY LICENSE",
            "identifier": "046.011398",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Divyasri Gongireddy
• Bridget Gongol, MD
• Dmitriy Gonikman
• Reem Gonnah, MD
• Leah Elizabeth Gonneville, PA-C
• Nirmala Gonsalves, MD
• Shirley Gonsalves
• Katherine M Gonsch, PT, DPT
• Michael J Gontarek, DC
• Madeleine Rose Gonte, MD, MPH

• Optometrist in Chicago, IL
• Providers in Chicago, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.