Individual provider Active NPI

Patrice Lee Romanick Gallagher, PHD

  • Psychologist
  • Springfield, MA
National Provider Identifier
1306988795
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY7598 Issued in MA
Practice address
3300 Main St FL 4
Springfield, MA 01107-1112
Phone
(413) 794-5555
Fax
(413) 794-7140
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY7598 MA Primary

Addresses

Primary practice location

3300 Main St FL 4
Springfield, MA 01107-1112

Mailing address

280 Chestnut St FL 2
Springfield, MA 01199-1001
Phone (413) 794-5700

Other practice location 1

52 Cedar Street
Psychiatry & Family Counseling
Worcester, MA 01609
Phone (508) 752-5191

Other practice location 2

900 Union St
Westborough, MA 01581-5408
Phone (508) 856-0732

Other identifiers 1

IdentifierTypeStateIssuer
110117203AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20110831000798 MA Practitioner - Clinical Psychologist 3779686233 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY7598MAMDPsychologist
7598MAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Medical Group, Inc CurrentSince Dec 5, 2017 Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

225 New Lancaster Rd
Leominster, MA 01453
Phone (978) 466-3208

900 Union St
Westborough, MA 01581
Phone (508) 871-0700

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

5 Neponset St
#2
Worcester, MA 01606

Interoperability endpoints

  • Direct secure messaging: patrice.gallagher.npi1306988795.reliant@direct.optumcare.masshiway.net

Organizations & group practices 2

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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1306988795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CHESTNUT ST FL 2",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991001",
            "telephone_number": "413-794-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 MAIN ST FL 4",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071112",
            "telephone_number": "413-794-5555",
            "fax_number": "413-794-7140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "52 Cedar Street",
            "address_2": "Psychiatry & Family Counseling",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "01609",
            "country_code": "US",
            "telephone_number": "508-752-5191",
            "fax_number": "508-792-1514",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 Union St",
            "address_purpose": "LOCATION",
            "city": "Westborough",
            "state": "MA",
            "postal_code": "015815408",
            "country_code": "US",
            "telephone_number": "508-856-0732",
            "fax_number": "508-425-5126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "PATRICE",
        "middle_name": "LEE ROMANICK",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "PSY7598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110117203A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.