Gina Marie O'Callaghan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601006884 Issued in MI

Practice address

3000 Old Centre Rd
Portage, MI 49024-4883

Phone

(269) 321-7546

Fax

(269) 321-1705

NPI assigned

Feb 4, 2014

Last updated

Sep 28, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, SC2 enrollments

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.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bay Street Orthopaedics PLLC

  • Orthopaedic Surgery Physician
  • Petoskey, MI
  • NPI 1174808992
  Medicare reassignment
• Tova Rogers MD Mfa PLLC

  dba Rogers Dermatology

  • Dermatology Physician
  • Charlevoix, MI
  • NPI 1336865112
  Medicare reassignment
• University Medical Associates of the Medical University of South Carol

  dba MUSC Physicians

  • Multi-Specialty Clinic/Center
  • Charleston, SC
  • NPI 1043241110
  Medicare reassignment
• Bay Street Orthopaedics PLLC

  • Durable Medical Equipment & Medical Supplies
  • Gaylord, MI
  • NPI 1982238705
  NPD
• University Medical Associates of the Medical University of South Carol

  dba MUSC PHysicians

  • Family Medicine Physician
  • Charleston, SC
  • NPI 1982678496

  Physician Assistant

  NPD
• Dermatology and Laser Center of Charleston PA

  • Dermatology Physician
  • Charleston, SC
  • NPI 1124198361
  NPD (past)
• Epiphany Dermatology of South Carolina LLC

  • Dermatology Physician
  • Greenville, SC
  • NPI 1861565996
  NPD (past)

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

{
    "created_epoch": "1391472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1003239500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 HENRY TECKLENBURG DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145798",
            "telephone_number": "843-556-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 OLD CENTRE RD",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244883",
            "telephone_number": "269-321-7546",
            "fax_number": "269-321-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CALLAGHAN",
        "first_name": "GINA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-04",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2108",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Novel Responses, Inc.
• Augustin Nsabimana
• Nicole Marie Nugent, PA-C
• Jonathan Nykamp, FNP
• Rachel O'Boyle, MS, ATC
• Brittany O'Grady, BCBA
• Bonita J O'Reilly, FNP
• Barbara Joanne O'Rourke, MSW, LCSW
• Kara Oates, DC
• Occupational Therapy Plus PLLC

• Physician Assistant in Portage, MI
• Providers in Portage, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; 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.