Individual provider Active NPI

Lars Michael Galldin, MD

  • Anesthesiology Physician
  • Paterson, NJ
National Provider Identifier
1063640902
Registry record updated Mar 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA09229800 Issued in NJ
Practice address
703 Main St
Paterson, NJ 07503-2621
Phone
(973) 754-2790
Fax
(973) 754-2791
NPI assigned
Jun 30, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MA09229800 NJ Primary

Addresses

Primary practice location

703 Main St
Paterson, NJ 07503-2621

Mailing address

3998 Fair Ridge Dr
Suite 300
Fairfax, VA 22033-9590
Phone (703) 295-9360

Other identifiers 1

IdentifierTypeStateIssuer
0366579MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20180925001603 NY Practitioner - Anesthesiology 3274775945 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Anesthesia of New York, P.C.Group PAC ID 7719041102, 50 clinicians

Practice addresses (Care Compare)

2233 State Route 86
Saranac Lake, NY 12983-5644
Phone (518) 891-4141

Hospital & facility affiliations

  • Adirondack Medical Center - Saranac Lake Hospital, Saranac Lake, NY, CCN 330079
  • SLHS Massena, Inc Hospital, Massena, NY, CCN 331322

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alice Hyde Medical Center Current Accepting new patients
Premier Anesthesia of New York, P.C. Anesthesiology CurrentSince Feb 15, 2024 Accepting new patients
Champlain Valley Physicians Hospital Medical Center Anesthesiology CurrentSince Aug 1, 2018 Accepting new patients
Alice Hyde Medical Center CurrentSince Mar 1, 2019 Accepting new patients
Alice Hyde Medical Center Past Accepting new patients

Locations

1 Hospital Dr
Massena, NY 13662
Phone (315) 764-1711

969 State Route 11
Moira, NY 12957
Phone (518) 529-7847

75 Beekman St
Plattsburgh, NY 12901
Phone (518) 562-7100

2233 State Route 86
Saranac Lake, NY 12983
Phone (518) 891-4141

Interoperability endpoints

  • Direct secure messaging: lgalldin262662@direct.uvmhealth.org

Organizations & group practices 5

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 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": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426809600000",
    "number": "1063640902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3998 FAIR RIDGE DR",
            "address_2": "SUITE 300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220339590",
            "telephone_number": "703-295-9360",
            "fax_number": "703-766-9725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 MAIN ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032621",
            "telephone_number": "973-754-2790",
            "fax_number": "973-754-2791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLDIN",
        "first_name": "LARS",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-30",
        "last_updated": "2015-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA09229800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0366579",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

Verify at the official NPI Registry.