Individual provider Active NPI

Frank J Pangallo, MD

  • Family Medicine Physician
  • Seymour, IN
National Provider Identifier
1215935010
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01067541A Issued in IN
Practice address
411 W Tipton St
Seymour, IN 47274-2363
Phone
(812) 522-2349
NPI assigned
Jul 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01067541A IN
Family Medicine Physician 207Q00000X 036078511 IL
Family Medicine Physician 207Q00000X 01067541A IN Primary

Addresses

Primary practice location

411 W Tipton St
Seymour, IN 47274-2363

Mailing address

307 S Evergreen Ave
Woodbury, NJ 08096-2739
Phone (856) 686-4335

Other identifiers 2

IdentifierTypeStateIssuer
036078511MedicaidIL
04532206OtherILBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20101025000988 IN Practitioner - Family PracticePractitioner - Emergency Medicine 7810956034 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036078511ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Professionals of Indiana, P.C. Emergency Medicine CurrentSince Nov 1, 2018 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince May 22, 2024 Accepting new patients
Cep America LLC Emergency Medicine Current Accepting new patients
Decatur County Memorial Hospital Current Accepting new patients
Cep America LLC Emergency Medicine CurrentSince May 22, 2024 Accepting new patients
Indiana Emergency Professionals PC Emergency Medicine CurrentSince Jan 1, 2011 Accepting new patients
Greater Elgin Emergency Specialists LTD Emergency Medicine Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2015 Jackson St
Anderson, IN 46016
Phone (765) 646-8243

3700 Washington Ave
Evansville, IN 47714
Phone (812) 232-0021

720 N Lincoln St
Greensburg, IN 47240
Phone (812) 522-2349

600 Wilson Creek Rd
Lawrenceburg, IN 47025
Phone (812) 532-2700

411 W Tipton St
Seymour, IN 47274
Phone (317) 888-3505

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

307 S Evergreen Ave
Woodbury, NJ 08096
Phone (856) 686-4300

Interoperability endpoints

  • Direct secure messaging: frank.pangallo@direct.dcmh.net

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": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1215935010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 S EVERGREEN AVE",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080962739",
            "telephone_number": "856-686-4335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W TIPTON ST",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472742363",
            "telephone_number": "812-522-2349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANGALLO",
        "first_name": "FRANK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01067541A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036078511",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01067541A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036078511",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "04532206",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seymour, IN

Sources for this page

Verify at the official NPI Registry.