Individual provider Active NPI

Maria Galanos

  • Emergency Medicine Physician
  • O Fallon, IL
National Provider Identifier
1073609814
Registry record updated Jan 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036-106666 Issued in IL
Practice address
103 N Oak St
O Fallon, IL 62269-1165
Phone
(618) 624-3368
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2009

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 036-106666 IL Primary

Addresses

Primary practice location

103 N Oak St
O Fallon, IL 62269-1165

Mailing address

103 N Oak St
O Fallon, IL 62269-1165

Other identifiers 2

IdentifierTypeStateIssuer
036106666OtherILBLUE SHIELD
036106666-4MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20051019000087 IL Practitioner - Emergency Medicine 3971529926 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.75 of 100Reported as individual
Quality
92.55
Improvement activities
0
Cost
79.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-106666ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary'S Hospital, Centralia, Illinois Emergency Medicine CurrentSince Sep 1, 2005 Accepting new patients
St. Mary'S Hospital, Centralia, Illinois CurrentSince Sep 1, 2005 Accepting new patients
Midwest Emergency Centralia Campus Associates, Inc Emergency Medicine CurrentSince Jun 1, 2012 Accepting new patients
HSHS Holy Family Hospital Inc Past Accepting new patients

Locations

400 N Pleasant Ave
Centralia, IL 62801
Phone (618) 436-5221

7420 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-3155

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233187200000",
    "number": "1073609814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 N OAK ST",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 N OAK ST",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691165",
            "telephone_number": "618-624-3368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALANOS",
        "first_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2009-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-106666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "036106666",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036106666-4",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, IL

Sources for this page

Verify at the official NPI Registry.