Individual provider Active NPI

Jeffrey Paul Gally, M.D.

  • Internal Medicine Physician
  • Coconut Creek, FL
National Provider Identifier
1114084274
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0054889 Issued in FL
Practice address
3880 Coconut Creek Pkwy
Suite 102
Coconut Creek, FL 33066-1652
Phone
(954) 971-6188
Fax
(954) 970-4944
NPI assigned
Jan 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME0054889 FL Primary

Addresses

Primary practice location

3880 Coconut Creek Pkwy
Suite 102
Coconut Creek, FL 33066-1652

Mailing address

3880 Coconut Creek Pkwy
Suite 102
Coconut Creek, FL 33066-1652
Phone (954) 971-6188

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
I20110509000832 FL Practitioner - Internal Medicine 1254517295 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3880 Coconut Creek Pkwy
Suite 102
Coconut Creek, FL 33066-1643
Phone (954) 971-6188

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0054889FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffrey Paul Gally, M.D.,P.a. Internal Medicine CurrentSince Jun 19, 2010 Accepting new patients

Locations

3880 Coconut Creek Pkwy
Ste 102
Coconut Creek, FL 33066
Phone (305) 971-6188

Organizations & group practices 1

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": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114084274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3880 COCONUT CREEK PKWY",
            "address_2": "SUITE 102",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330661652",
            "telephone_number": "954-971-6188",
            "fax_number": "954-970-4944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3880 COCONUT CREEK PKWY",
            "address_2": "SUITE 102",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330661652",
            "telephone_number": "954-971-6188",
            "fax_number": "954-970-4944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLY",
        "first_name": "JEFFREY",
        "middle_name": "PAUL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0054889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coconut Creek, FL

Sources for this page

Verify at the official NPI Registry.