Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Crystal Goncalves, AGACNP-BC

Individual provider Nurse Practitioner · NPI 1811758758

Mrs. Crystal Goncalves, AGACNP-BC is a Nurse Practitioner in Providence, Rhode Island. Qualified in 2023, 3 years ago. Practices with Lifespan Physician Group Inc, a 1,125-clinician group and accepts Medicare assignment. Licensed in Rhode Island.

Years since qualifying
3
Licensed in
RI
In the registry since
2024
Specialties on file
2
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Practice location Address checks out

593 Eddy St
Providence, RI 02903-4923
Phone: (401) 444-5891
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence APRN03865 (RI)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence APRN03865 (RI)

Record details

NPI number1811758758
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGACNP-BC
Sole proprietorNo
NPI enumeratedJanuary 18, 2024
Last updated in NPPESMarch 15, 2024
Certification dateMarch 15, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Lifespan Physician Group Inc — 1125 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Providence