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ZENOBIA GONSALVES MD
NPI 1720511447
Student in an Organized Health Care Education/Training Program in Lake Grove, NY

Active since April 10, 2017
100/100
CMS Quality Rating
4 SMITH HAVEN MALL STE 112, LAKE GROVE, NY 11755(631) 444-4686 Get Directions Write a Review

NPPES record last updated: September 5, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 5, 2025, Apr 10, 2017 (2 updates tracked since 2017).

About Zenobia Gonsalves Md NPPES

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

ZENOBIA GONSALVES MD (NPI 1720511447) is an individual student in an organized health care education/training program in Lake Grove, New York and active in the NPI registry since April 2017.

NPPES Registry Identity

NPI1720511447
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameZENOBIA GONSALVESCredential: MD
Location Address4 SMITH HAVEN MALL STE 112Lake Grove, NY 11755-1219
Mailing Address101 Nicolls Road, Hsc T9-030Stony Brook, NY 11794 · (631) 444-7650
Phone(631) 444-4686
Sole ProprietorNo
Enumeration DateApril 10, 2017
Last NPPES UpdateSeptember 5, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 5, 2025
✔ NPI 1720511447 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

4 SMITH HAVEN MALL STE 112, Lake Grove, NY 11755
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Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 2

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

EMILY HARLAN STETLER MD
Obstetrics & Gynecology (Maternal & Fetal Medicine)
4 SMITH HAVEN MALL STE 112
LAKE GROVE, NY 11755
Suffolk County (631) 444-4686
LAUREN KOLLAR
Nurse Practitioner (Family)
4 SMITH HAVEN MALL STE 112
LAKE GROVE, NY 11755
Suffolk County (631) 444-4686

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Zenobia Gonsalves's NPI number?

The NPI number for Zenobia Gonsalves is 1720511447. It was assigned to this individual provider in the NPPES registry on April 10, 2017.

Where is Zenobia Gonsalves located?

Zenobia Gonsalves practices at 4 Smith Haven Mall Ste 112, Lake Grove, NY 11755. The listed phone number is (631) 444-4686.

What is Zenobia Gonsalves's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Zenobia Gonsalves was last updated on September 5, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.