Individual provider Active NPI

Patricia A Gallant, PA-C

  • Physician Assistant
  • Belmont, NH
National Provider Identifier
1104040112
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1366 Issued in NH
Practice address
77 Daniel Webster Hwy
Belmont, NH 03220-3028
Phone
(603) 737-0550
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1366 NH Primary
Physician Assistant 363A00000X 1156 MA

Addresses

Primary practice location

77 Daniel Webster Hwy
Belmont, NH 03220-3028

Mailing address

360 US Highway 1 Byp Unit 102
Portsmouth, NH 03801-7105
Phone (603) 410-6700

Other practice location 1

1515 Allen St
Springfield, MA 01118-1803
Phone (413) 783-9114

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180709000370 NH Practitioner - Physician Assistant 4082782156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Convenientmd - FFS UC LLCGroup PAC ID 5193186492, 397 clinicians

Practice addresses (Care Compare)

3 Nashua Rd
Bedford, NH 03110-5515
Phone (603) 472-6700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1366NHMDClinical Social Worker
1156MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Convenientmd - FFS UC LLC CurrentSince Aug 1, 2023 Accepting new patients
Convenientmd - FFS UC LLC CurrentSince Aug 1, 2023 Accepting new patients
Urgent Care Physicians PC PastSince Mar 15, 2007 Accepting new patients
Convenientmd - FFS UC LLC Past Accepting new patients

Locations

3 Nashua Rd
Bedford, NH 03110
Phone (603) 472-6700

77 Daniel Webster Hwy
Belmont, NH 03220
Phone (603) 737-0500

111 New Hampshire Ave
Portsmouth, NH 03801

360 US Highway 1 Byp
Unit 102
Portsmouth, NH 03801
Phone (603) 410-6700

125 Indian Rock Rd
Windham, NH 03087
Phone (603) 890-6330

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.

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1104040112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 US HIGHWAY 1 BYP UNIT 102",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017105",
            "telephone_number": "603-410-6700",
            "fax_number": "603-319-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 DANIEL WEBSTER HWY",
            "city": "BELMONT",
            "state": "NH",
            "postal_code": "032203028",
            "telephone_number": "603-737-0550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 Allen St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "011181803",
            "country_code": "US",
            "telephone_number": "413-783-9114",
            "fax_number": "413-782-0960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLANT",
        "first_name": "PATRICIA",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "1366",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "1156",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, NH

Sources for this page

Verify at the official NPI Registry.