Individual provider Active NPI

Melissa M Gallagher, NP

  • Family Nurse Practitioner
  • Holbrook, NY
National Provider Identifier
1336956473
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
355235 Issued in NY
Practice address
233 Union Ave
Holbrook, NY 11741-1820
Phone
(212) 803-3339
NPI assigned
Dec 12, 2024
Last updated
Dec 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 355235 NY Primary

Addresses

Primary practice location

233 Union Ave
Holbrook, NY 11741-1820

Mailing address

5141 Nesconset Hwy # 1046
Port Jefferson Station, NY 11776-1355

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250122001630 NY Practitioner - Nurse Practitioner 7911436829 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mission Medical Care PCGroup PAC ID 2365705696, 54 clinicians

Practice addresses (Care Compare)

165 N Village Ave
Rockville Centre, NY 11570-3701
Phone (212) 803-3339

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
355235NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mission Medical Care PC Family CurrentSince Nov 17, 2024 Accepting new patients
Fara Stricker Family Health Nurse Practitioner, P.C. PastSince May 14, 2023 Accepting new patients

Locations

233 Union Ave
Ste 105
Holbrook, NY 11741
Phone (631) 285-7311

1228 E Main St
Ste A
Riverhead, NY 11901
Phone 63169643572

165 N Village Ave
Ste 133
Rockville Ctr, NY 11570
Phone (516) 764-0879

265 Sunrise Hwy
Ste 1274
Rockville Ctr, NY 11570

609 Hampton Rd
Ste 9
Southampton, NY 11968

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, 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": "1733961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1336956473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5141 NESCONSET HWY # 1046",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 UNION AVE",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117411820",
            "telephone_number": "212-803-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "MELISSA",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-12",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "355235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holbrook, NY

Sources for this page

Verify at the official NPI Registry.