Individual provider Active NPI

Priscila Hermont Barcellos Goncalves, M.D.

  • Hematology & Oncology Physician
  • New Hyde Park, NY
National Provider Identifier
1851539902
Registry record updated Mar 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
28944 Issued in NY
Practice address
450 Lakeville Rd
New Hyde Park, NY 11042-1118
Phone
(516) 734-8976
NPI assigned
Jan 28, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 28944 NY Primary

Addresses

Primary practice location

450 Lakeville Rd
New Hyde Park, NY 11042-1118

Mailing address

450 Lakeville Rd
New Hyde Park, NY 11042-1118

Other practice location 1

42021 St Antoine
Detroit, MI 48201-2153
Phone (313) 745-4832

Medicare participation

Medicare enrollment files
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.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28944NYMDHematology & Oncology Physician

NPI Registry JSON

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

{
    "created_epoch": "1233100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520467200000",
    "number": "1851539902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 LAKEVILLE RD",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 LAKEVILLE RD",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421118",
            "telephone_number": "516-734-8976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "42021 St Antoine",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012153",
            "country_code": "US",
            "telephone_number": "313-745-4832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERMONT BARCELLOS GONCALVES",
        "first_name": "PRISCILA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-28",
        "last_updated": "2018-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "28944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.