Rebecca Z Gallagher, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

50254 Issued in WI

Practice address

4607 Vettelson Road
Hartland, WI 53029

Phone

(262) 367-1717

NPI assigned

Nov 10, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2018 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1063583300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32645 WEST ESKER LN",
            "city": "NASHOTAH",
            "state": "WI",
            "postal_code": "53058",
            "telephone_number": "262-367-1717",
            "fax_number": "262-458-4547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4607 VETTELSON ROAD",
            "city": "HARTLAND",
            "state": "WI",
            "postal_code": "53029",
            "telephone_number": "262-367-1717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "WI",
            "postal_code": "530983303",
            "country_code": "US",
            "telephone_number": "920-262-4570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "REBECCA",
        "middle_name": "Z",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "50254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063583300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Hartland, WI
• Providers in Hartland, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.