Individual provider Active NPI

Charles Paul Gallo, PHD

  • Psychologist
  • Monroeville, PA
National Provider Identifier
1225029853
Registry record updated Jul 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS002567L Issued in PA
Practice address
2550 Mosside Blvd
Suite 304
Monroeville, PA 15146-3540
Phone
(412) 373-3471
Fax
(412) 373-7324
NPI assigned
Nov 2, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS002567L PA Primary

Addresses

Primary practice location

2550 Mosside Blvd
Suite 304
Monroeville, PA 15146-3540

Mailing address

2550 Mosside Blvd
Suite 304
Monroeville, PA 15146-3540
Phone (412) 373-3471

Other identifiers 3

IdentifierTypeStateIssuer
063720OtherPAHIGHMARK
279688OtherPAVALUE OPTIONS
001466063MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031106000003 PA Practitioner - Clinical Psychologist 2062324445 Receives reassigned benefits from 6 practitioners
Practice locations: Monroeville, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2550 Mosside Blvd
Suite 304
Monroeville, PA 15146-3532
Phone (412) 373-3471

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Charles P. Gallo Psychologist PastSince Jan 1, 1990 Accepting new patients
Charles P. Gallo Psychologist PastSince Jan 1, 1990 Accepting new patients
Charles P. Gallo Psychologist PastSince Jan 1, 1990 Accepting new patients
Gallo Eye Surgical, Assoc, Inc Past Accepting new patients
Charles P. Gallo PastSince Jan 1, 1990 Accepting new patients

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Organizations & group practices 5

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": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374105600000",
    "number": "1225029853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 MOSSIDE BLVD",
            "address_2": "SUITE 304",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151463540",
            "telephone_number": "412-373-3471",
            "fax_number": "412-373-7324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 MOSSIDE BLVD",
            "address_2": "SUITE 304",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151463540",
            "telephone_number": "412-373-3471",
            "fax_number": "412-373-7324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLO",
        "first_name": "CHARLES",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2013-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS002567L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "063720",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "279688",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001466063",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroeville, PA

Sources for this page

Verify at the official NPI Registry.