Individual provider Active NPI

Andrew S. Gallant, M.D.

  • Specialist
  • Stuart, FL
National Provider Identifier
1194859454
Registry record updated Feb 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME0061896 Issued in FL
Practice address
1615 NW Federal Hwy
Stuart, FL 34994-9629
Phone
(772) 878-5858
Fax
(772) 692-2480
NPI assigned
Mar 16, 2007
Last updated
Feb 26, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME0061896 FL Primary

Addresses

Primary practice location

1615 NW Federal Hwy
Stuart, FL 34994-9629

Mailing address

1615 NW Federal Hwy
Stuart, FL 34994-9629
Phone (772) 878-5858

Other identifiers 2

IdentifierTypeStateIssuer
2654385 00MedicaidFL
V2628OtherFLBCBS#

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0061896FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Imaging LLC Current Accepting new patients
Diagnostic Imaging Services Inc PastSince Jan 1, 1990 Accepting new patients
Elite Imaging, LLC Past Accepting new patients

Locations

8300 W Sunrise Blvd
Plantation, FL 33322
Phone (954) 577-6000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393372800000",
    "number": "1194859454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 NW FEDERAL HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349949629",
            "telephone_number": "772-878-5858",
            "fax_number": "772-692-2480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 NW FEDERAL HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349949629",
            "telephone_number": "772-878-5858",
            "fax_number": "772-692-2480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLANT",
        "first_name": "ANDREW",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2014-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0061896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2654385 00",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS#",
            "identifier": "V2628",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.