Individual provider Active NPI

Michael Bradley Galloway, OTR/L

  • Occupational Therapist
  • Frisco, TX
National Provider Identifier
1023696416
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
120566 Issued in TX
Practice address
8845 Gary Burns Dr Ste 100
Frisco, TX 75034-2503
Phone
(469) 403-2090
Fax
(469) 237-3462
NPI assigned
Mar 29, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 120566 TX Primary

Addresses

Primary practice location

8845 Gary Burns Dr Ste 100
Frisco, TX 75034-2503

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other practice location 1

3405 Midway Rd Ste 500
Plano, TX 75093-8139
Phone (972) 473-0229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230911001031 TX Practitioner - Occupational Therapist in Private Practice 9335503382 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8845 Gary Burns Dr
Suite 100
Frisco, TX 75034-2503
Phone (972) 979-6577

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
120566TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Occupational Therapist CurrentSince Aug 15, 2023 Accepting new patients
Athletico LTD CurrentSince Aug 15, 2023 Accepting new patients
Ideal Physical Therapy of Texas LLC CurrentSince Oct 14, 2024 Accepting new patients
Ideal Physical Therapy of Texas LLC Occupational Therapist CurrentSince Oct 14, 2024 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

4100 Fairway Dr
Ste 400
Carrollton, TX 75010
Phone (972) 394-3325

5615 Colleyville Blvd
Ste 130
Colleyville, TX 76034
Phone (817) 576-0995

8845 Gary Burns Dr
Ste 100
Frisco, TX 75034
Phone (469) 403-2090

125 N MacArthur Blvd
Irving, TX 75061
Phone (972) 887-3318

4770 State Highway 121
Ste 130
Lewisville, TX 75056
Phone (469) 664-0026

5400 Brodie Ln
Ste 295
Sunset Valley, TX 78745
Phone (512) 676-3949

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1023696416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8845 GARY BURNS DR STE 100",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750342503",
            "telephone_number": "469-403-2090",
            "fax_number": "469-237-3462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3405 Midway Rd Ste 500",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750938139",
            "country_code": "US",
            "telephone_number": "972-473-0229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLOWAY",
        "first_name": "MICHAEL",
        "middle_name": "BRADLEY",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-29",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "120566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.