Thomas John Galisin, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

104083 Issued in NC

Practice address

2906 N Main St
Tarboro, NC 27886-1921

Phone

(252) 823-7212

Fax

(252) 641-7286

NPI assigned

Dec 28, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Physician Assistant

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Proactive Therapy of North Carolina IncGroup PAC ID 6305753120, shared by 5 NPIs, 540 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vidant Edgecombe Hospital Hospital, Tarboro, NC, CCN 340107

Merit-based Incentive Payment System (MIPS)

Final score

96.95 of 100Reported as apm

Quality

82.44

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/6545/brand/1/csg/1/fhir/r4

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.

• Vidant Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Greenville, NC
  • NPI 1477648731
  Medicare reassignment Care Compare group NPD
• Carolina Regional Orthopaedics, PA

  • Orthopaedic Surgery Physician
  • Tarboro, NC
  • NPI 1073553509
  Medicare reassignment NPD
• Vidant Medical Group LLC

  • Ambulatory Surgical Clinic/Center
  • Kinston, NC
  • NPI 1376049619
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• East Carolina Health - Heritage Inc

  • General Acute Care Hospital
  • Tarboro, NC
  • NPI 1699757393
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1376520684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2906 N MAIN ST",
            "city": "TARBORO",
            "state": "NC",
            "postal_code": "278861921",
            "telephone_number": "252-823-7212",
            "fax_number": "252-641-7286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2906 N MAIN ST",
            "city": "TARBORO",
            "state": "NC",
            "postal_code": "278861921",
            "telephone_number": "252-823-7212",
            "fax_number": "252-641-7286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALISIN",
        "first_name": "THOMAS",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "104083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tgalisin31369@direct.vidanthealth.com",
            "affiliation": "N",
            "address_1": "2100 Stantonsburg Rd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278342818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Fountain Adult Home Care, LLC
• Fountain Transportation
• Lavone Freeman
• Paula Elizabeth Fulford, PT, DPT
• Karen Suzanne Gaither, PTA
• Eileen Pauline Gentry, FNP-C
• Lashaunda Antoinette Gilbert, LCSW-A
• Global Connection
• Roxanne Wynne Godley, MS, RD, LDN
• Amy Goldweber

• Physician Assistant in Tarboro, NC
• Providers in Tarboro, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.