Katherine Gallagher, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00542400 Issued in NJ

Practice address

1771 Madison Ave
Lakewood, NJ 08701-1242

Phone

(732) 364-2144

Fax

(732) 364-3559

NPI assigned

Mar 18, 2015

Last updated

Jun 15, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Miss Katherine McGillivray Former name

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lakewood Resource and Referral Center IncGroup PAC ID 6901981497, 106 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Monmouth Medical Center-Southern Campus Hospital, Lakewood, NJ, CCN 310084

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: katherine.gallagher@chemed.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lakewood Resource and Referral Center Inc

  dba Center for Health Education, Medicine and Dentistry

  • Federally Qualified Health Center (FQHC)
  • Lakewood, NJ
  • NPI 1083748297
  Medicare reassignment Care Compare group NPD (past)
• Lakewood Resource and Referral Center, Inc.

  dba Center for Health Education, Medicine and Dentistry

  • Federally Qualified Health Center (FQHC)
  • Jackson, NJ
  • NPI 1124844816
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Monmouth Medical Center Inc

  dba Monmouth Medical Center Southern Campus

  • General Acute Care Hospital
  • Lakewood, NJ
  • NPI 1225133473
  Care Compare affiliation
• Monmouth Medical Center Inc

  • General Acute Care Hospital
  • Long Branch, NJ
  • NPI 1609983790
  Care Compare affiliation

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

{
    "created_epoch": "1426636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1144613944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1771 MADISON AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087011242",
            "telephone_number": "723-364-2144",
            "fax_number": "732-364-3559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1771 MADISON AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087011242",
            "telephone_number": "732-364-2144",
            "fax_number": "732-364-3559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "KATHERINE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-18",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00542400",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "OA003521",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA057488",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "MCGILLIVRAY",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mindy Furst, MSED, BCBA
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• Suzanne Gabriele
• Richard L Gaines, DMD
• Maryanne Galloway, LCSW
• Moira Gambarony, LSW
• Panchali Ganguly, M.D
• Bina Ganz, OTR/L
• Chana Ganz, RDN

• Physician Assistant in Lakewood, NJ
• Providers in Lakewood, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.