Nicholas Goncalves, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA8651 Issued in NY

Practice address

5141 Broadway
New York, NY 10034-1159

Phone

(212) 932-4000

NPI assigned

Jun 2, 2021

Last updated

Sep 18, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1679149314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5141 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100341159",
            "telephone_number": "212-932-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5141 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100341159",
            "telephone_number": "212-932-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONCALVES",
        "first_name": "NICHOLAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-02",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "PA8651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriela Andrea Goncalves, MA, CCC-SLP
• Isabel Mariana Goncalves
• Lindsey M Goncalves, MS, CCC-SLP
• Marcus Dasilva Goncalves, M.D., PH.D.
• Meryann Goncalves
• Dimitry Goncharov, DO
• Oleg Goncharov, DDS
• Tamas Gonda, M.D.
• Suma Gondi
• Gabriel Gondolesi, MD

• Physician Assistant in New York, NY
• Providers in New York, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.