Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

NICHOLAS GONSALVES M.D.
NPI 1124553987
Surgery in Oakland, CA

Q: What is Nicholas Gonsalves's NPI number?

The NPI number for Nicholas Gonsalves is 1124553987. It was assigned to this individual provider in the NPPES registry on April 28, 2017.

Q: What is Nicholas Gonsalves's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Active since April 28, 2017PECOS Enrolled

365 HAWTHORNE AVE STE 101, OAKLAND, CA 94609(510) 465-5523 Get Directions Write a Review

NPPES record last updated: July 30, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 30, 2026, Aug 4, 2025, Apr 28, 2017 (3 updates tracked since 2017).

On this page

About Nicholas Gonsalves M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICHOLAS GONSALVES M.D. (NPI 1124553987) is an individual surgery provider in Oakland, California, licensed in California (A163255) and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (2016).

NPPES Registry Identity

NPI1124553987

Entity TypeIndividualMale

Primary Taxonomy208600000X

Provider Legal NameNICHOLAS GONSALVESCredential: M.D.

Location Address365 HAWTHORNE AVE STE 101Oakland, CA 94609-3115

Mailing Address365 Hawthorne Ave Ste 101Oakland, CA 94609-3115 · (510) 465-5523

Phone(510) 465-5523

Sole ProprietorNo

Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 2016

Enumeration DateApril 28, 2017

Last NPPES UpdateJuly 30, 20263 updates tracked since enumeration

NPPES CertifiedJuly 30, 2026

✔ NPI 1124553987 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

License✔ Licensed in CA · A163255

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

365 HAWTHORNE AVE STE 101, Oakland, CA 94609

Open in Google Maps ↗

Secondary Practice Locations 2

Location 127206 Calaroga Ave Ste 206Hayward, CA 94545-4300 · Phone (510) 732-5731

Location 24445 Magnolia AveRiverside, CA 92501-4135 · Phone (951) 788-3000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicholas Gonsalves M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7719485168

PECOS Enrollment IDI20250813003755

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94609 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$104.51 typical visit price

range $69.00 – $202.35

Typical copayment $26.12 (range $17.25 – $50.58)

Most-billed visit code 99203

Established Patient

$84.91 typical visit price

range $23.44 – $166.46

Typical copayment $21.22 (range $5.86 – $41.61)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HNOUKAJ AURORE LYFOUNG MD

Surgery