Individual provider Active NPI

Jacqueline Aliotta Gallup, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Baltimore, MD
National Provider Identifier
1285053934
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
D0100947 Issued in MD
Practice address
1800 Orleans Street
Baltimore, MD 21264-4830
Phone
(410) 955-5000
NPI assigned
Apr 9, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 290320 NY
Neonatal-Perinatal Medicine Physician 2080N0001X D0100947 MD Primary

Addresses

Primary practice location

1800 Orleans Street
Baltimore, MD 21264-4830

Mailing address

6201 Greenleigh Ave
Middle River, MD 21220-2004
Phone (410) 933-6423

Other practice location 1

1656 Champlin Ave
Utica, NY 13502-4830
Phone (518) 262-3095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20240710004574 MD Practitioner - Pediatric Medicine 0648715920 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0100947MDMDNeonatal-Perinatal Medicine Physician
290320NYMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University Neonatal-Perinatal Medicine CurrentSince Jul 1, 2024 Accepting new patients
Johns Hopkins University CurrentSince Jul 1, 2024 Accepting new patients
Johns Hopkins University Current Accepting new patients
The Johns Hopkins Hospital Past Accepting new patients

Locations

601 N Caroline St
Baltimore, MD 21287
Phone (410) 955-5080

1800 Orleans St
Baltimore, MD 21287
Phone (410) 502-2037

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

Interoperability endpoints

  • Direct secure messaging: jgallup29351@mvhealthsystem.direct-ci.com
  • Direct secure messaging: jgallup1240327@direct.hopkinsmedicine.org

Organizations & group practices 4

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": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1285053934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004",
            "telephone_number": "410-933-6423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 ORLEANS STREET",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644830",
            "telephone_number": "410-955-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1656 Champlin Ave",
            "address_purpose": "LOCATION",
            "city": "Utica",
            "state": "NY",
            "postal_code": "135024830",
            "country_code": "US",
            "telephone_number": "518-262-3095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLUP",
        "first_name": "JACQUELINE",
        "middle_name": "ALIOTTA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-09",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NY",
            "license": "290320",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MD",
            "license": "D0100947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.