Laura Jean Gallistel, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

51423-021 Issued in WI

Practice address

555 Redbird Cir Ste 200
De Pere, WI 54115-7979

Phone

(920) 338-6820

NPI assigned

Jan 17, 2006

Last updated

Feb 24, 2011By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lgallistel32400@direct.thedacare.org
• Direct secure messaging: lgallistel926380@direct.emplifyhealth.org

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.

• Bellin Memorial Hospital Inc

  dba Bellin Health Algoma

  • Rural Health Clinic/Center
  • Algoma, WI
  • NPI 1609838473
  Medicare reassignment NPD
• Bellin Memorial Hospital Inc

  dba FMC Pediatrics West

  • Pediatrics Physician
  • Green Bay, WI
  • NPI 1871556134
  NPD
• Bellin Memorial Hospital Inc

  dba Bellin Health Heart and Vascular Oconto

  • Cardiovascular Disease Physician
  • Oconto, WI
  • NPI 1699926964
  NPD (past)
• Bellin Memorial Hospital Inc

  dba FMC Brillion

  • Family Medicine Physician
  • Brillion, WI
  • NPI 1962464784
  NPD (past)

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298505600000",
    "number": "1013997121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 REDBIRD CIR STE 200",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541157979",
            "telephone_number": "920-338-6820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 REDBIRD CIR STE 200",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541157979",
            "telephone_number": "920-338-6820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLISTEL",
        "first_name": "LAURA",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-17",
        "last_updated": "2011-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "51423-021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie E Froling, APNP
• Full Circle Therapy and Wellness LLC
• Full Swing Fitness and Rehabilitation LLC
• Megan Fye, RBT
• Steven Gale, M.D.
• Justine Marie Garbaciak, M.S.
• Ashley Gardon, LMFT
• Aleshia Garland, PT
• Sheila Jean Garrigan, LCSW
• Megan Rose Gasperich, PTA

• Pediatrics Physician in De Pere, WI
• Providers in De Pere, WI by specialty
• Pediatrics Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2011; 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.