Individual provider Active NPI

Teresa Gallo-Thys, DO

  • Internal Medicine Physician
  • Boynton Beach, FL
National Provider Identifier
1104137207
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS13449 Issued in FL
Practice address
2300 S Congress Ave Ste 105
Boynton Beach, FL 33426-7400
Phone
(561) 203-5282
Fax
(740) 212-8513
NPI assigned
Jun 24, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X E-7902 AR
Hospitalist Physician 208M00000X OS13449 FL
Internal Medicine Physician 207R00000X OS13449 FL Primary

Addresses

Primary practice location

2300 S Congress Ave Ste 105
Boynton Beach, FL 33426-7400

Mailing address

6615 W Boynton Beach Blvd Ste 412
Boynton Beach, FL 33437-3526
Phone (561) 882-4541

Other practice location 1

1309 N Flagler Dr
West Palm Beach, FL 33401-3406
Phone (561) 882-4541

Other names 1

  • Teresa Gallo Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address drgallothys@elitewellnesspb.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20150917002711 FL Practitioner - Internal Medicine 0840434890 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS13449FLMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Wellness Internal Medicine Inc Internal Medicine CurrentSince Apr 1, 2025 Accepting new patients
QMC LLC Hospitalist PastSince Feb 1, 2021 Accepting new patients
Florida Atlantic University Past Accepting new patients

Locations

2300 S Congress Ave
Ste 105
Boynton Beach, FL 33426
Phone (561) 733-5001

2300 S Congress Ave
Ste 1050
Boynton Beach, FL 33426

6615 W Boynton Beach Blvd
Boynton Beach, FL 33437
Phone (561) 266-4001

Organizations & group practices 3

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": "1277337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1104137207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6615 W BOYNTON BEACH BLVD STE 412",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334373526",
            "telephone_number": "561-882-4541",
            "fax_number": "561-650-6093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 S CONGRESS AVE STE 105",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334267400",
            "telephone_number": "561-203-5282",
            "fax_number": "740-212-8513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1309 N Flagler Dr",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334013406",
            "country_code": "US",
            "telephone_number": "561-882-4541",
            "fax_number": "561-650-6093",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLO-THYS",
        "first_name": "TERESA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-24",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AR",
            "license": "E-7902",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "OS13449",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS13449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drgallothys@elitewellnesspb.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2300 S Congress Ave Ste 105",
            "city": "Boynton Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334267400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "GALLO",
            "credential": "D.O.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.