Individual provider Active NPI

Kevin J Gallen, P.A.

  • Surgical Physician Assistant
  • Naples, FL
National Provider Identifier
1366412405
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9101773 Issued in FL
Practice address
1350 Tamiami TRL N
#202
Naples, FL 34102-5203
Phone
(239) 262-0020
Fax
(239) 262-5980
NPI assigned
Jan 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9101773 FL Primary

Addresses

Primary practice location

1350 Tamiami TRL N
#202
Naples, FL 34102-5203

Mailing address

1350 Tamiami TRL N
#202
Naples, FL 34102-5203
Phone (239) 262-0020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9101773FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Restoration Orthopedics PastSince Oct 1, 2002 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IACDAA

Organizations & group practices 1

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": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1366412405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 TAMIAMI TRL N",
            "address_2": "#202",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025203",
            "telephone_number": "239-262-0020",
            "fax_number": "239-262-5980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 TAMIAMI TRL N",
            "address_2": "#202",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025203",
            "telephone_number": "239-262-0020",
            "fax_number": "239-262-5980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLEN",
        "first_name": "KEVIN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9101773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.