Individual provider Active NPI

Madison Galasso, M.D.

  • Emergency Medicine Physician
  • San Diego, CA
National Provider Identifier
1053766766
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A160982 Issued in CA
Practice address
4647 Zion Ave
San Diego, CA 92120-2507
Phone
(833) 574-2273
NPI assigned
May 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A160982 CA Primary

Addresses

Primary practice location

4647 Zion Ave
San Diego, CA 92120-2507

Mailing address

1281 9TH Ave Unit 919
San Diego, CA 92101-4650
Phone (716) 949-9870

Other practice location 1

9455 Clairemont Mesa Blvd
San Diego, CA 92123-1297
Phone (858) 266-5000

Other practice location 2

320 E North Ave
Pittsburgh, PA 15212-4756
Phone (412) 359-4905

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20191105002275 CA Practitioner - Emergency Medicine 8123316213 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centro de Salud de la Comunidad de San Ysidro,Inc.Group PAC ID 6901709435, 291 clinicians

Practice addresses (Care Compare)

678 3Rd Ave
Chula Vista, CA 91910-5736
Phone (619) 662-4100

Hospital & facility affiliations

  • Kaiser Foundation Hospital - San Diego Hospital, San Diego, CA, CCN 050515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A160982CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Centro de Salud de la Comunidad de San Ysidro Inc CurrentSince Dec 1, 2020 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. CurrentSince Dec 1, 2020 Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 2, 2019 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 2, 2019 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. Past Accepting new patients

Locations

1637 Third Ave
Ste B
Chula Vista, CA 91911
Phone (619) 425-1780

678 Third Ave
Chula Vista, CA 91910
Phone (619) 205-6349

333 H St
Ste 2080
Chula Vista, CA 91910

1136 D Ave
National City, CA 91950
Phone (619) 336-2300

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

9455 Clairemont Mesa Blvd
San Diego, CA 92123
Phone (858) 266-4200

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mgalasso18707@syhealth.direct-ci.com

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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": "1462060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1053766766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1281 9TH AVE UNIT 919",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921014650",
            "telephone_number": "716-949-9870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4647 ZION AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921202507",
            "telephone_number": "833-574-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9455 Clairemont Mesa Blvd",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921231297",
            "country_code": "US",
            "telephone_number": "858-266-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "320 E North Ave",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152124756",
            "country_code": "US",
            "telephone_number": "412-359-4905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALASSO",
        "first_name": "MADISON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-01",
        "last_updated": "2021-11-22",
        "certification_date": "2020-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A160982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.