NPIMap

Individual provider Active NPI

Fabian Gilbert Gallegos, MSN, APRN, AGACNP-BC

  • Hospitalist Physician
  • Yukon, OK
National Provider Identifier
1013529791
Registry record updated Oct 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
106503 Issued in OK
Practice address
1201 Health Center Pkwy
Yukon, OK 73099-6381
Phone
(888) 611-4429
NPI assigned
Aug 23, 2020
Last updated
Oct 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R0106503 OK
Hospitalist Physician 208M00000X 106503 OK Primary

Addresses

Primary practice location

1201 Health Center Pkwy
Yukon, OK 73099-6381

Mailing address

9813 SW 27TH St
Yukon, OK 73099-6977
Phone (405) 473-2263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210521000189 OK Practitioner - Nurse Practitioner 0143629212 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinton Hospital AuthorityGroup PAC ID 5092163873, 14 clinicians

Practice addresses (Care Compare)

100 N 30TH St
Clinton, OK 73601-3117
Phone (580) 574-5128

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
106503OKMDHospitalist Physician
R0106503OKMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians of Mid-America, P.C. Nurse Practitioner CurrentSince Mar 1, 2025 Accepting new patients
Midwest Hospital Medicine Associates PC Hospitalist CurrentSince Mar 12, 2021 Accepting new patients
Emergency Services of Oklahoma PC Nurse Practitioner CurrentSince Sep 1, 2021 Accepting new patients
Carnegie Tri-County Municipal Hospital Management, Inc CurrentSince May 1, 2021 Accepting new patients
Clinton Hospital Authority CurrentSince Jun 11, 2024 Accepting new patients
Cordell Memorial Hospital 0189 Current Accepting new patients
Advance Physicians Group CurrentSince May 1, 2021 Accepting new patients
Carnegie Tri-County Municipal Hospital Management, Inc. CurrentSince May 1, 2021 Accepting new patients
Clinton Hospital Authority CurrentSince Jun 11, 2024 Accepting new patients
Cordell Memorial Hospital 0189 Past Accepting new patients

Locations

102 N Broadway St
Carnegie, OK 73015
Phone (580) 654-1050

100 N 30th St
Clinton, OK 73601
Phone (580) 323-2363

1220 N Glenn L English St
Cordell, OK 73632
Phone (580) 832-3339

1221 N Kelly Ave
Ste 100
Edmond, OK 73003

4050 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 608-3200

4510 NW 39th St
Oklahoma City, OK 73122
Phone (405) 495-5841

1102 W MacArthur St
Shawnee, OK 74804
Phone (405) 273-2270

3701 E Main St
Weatherford, OK 73096
Phone (580) 772-5551

1201 Health Center Pkwy
Yukon, OK 73099
Phone (405) 717-6800

Interoperability endpoints

  • Direct secure messaging: fgallegos55245@direct-ehr-ssmhc.com
  • FHIR API: https://fhir-usa.unify.chbase.com/org/clinreg-bcebf7e2

Organizations & group practices 10

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1598140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633910400000",
    "number": "1013529791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9813 SW 27TH ST",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730996977",
            "telephone_number": "405-473-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 HEALTH CENTER PKWY",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730996381",
            "telephone_number": "888-611-4429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLEGOS",
        "first_name": "FABIAN",
        "middle_name": "GILBERT",
        "credential": "MSN, APRN, AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-23",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "R0106503",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OK",
            "license": "106503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yukon, OK

Sources for this page

Verify at the official NPI Registry.