Kathleen Forti-Gallant, FNP

Primary specialty

Medical-Surgical Clinical Nurse SpecialistTaxonomy code 364SM0705X

License

CNP81358 Issued in ME

Practice address

925 Union St Ste 3
Bangor, ME 04401-3051

Phone

(207) 973-9980

Fax

(207) 973-7515

NPI assigned

Jul 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

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

Nurse Practitioner

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Acadia Hospital Corp.Group PAC ID 7719878495, 88 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northern Light Sebasticook Valley Hospital Hospital, Pittsfield, ME, CCN 201313
• Northern Light Eastern Maine Medical Center Hospital, Bangor, ME, CCN 200033

Merit-based Incentive Payment System (MIPS)

Final score

47.43 of 100Reported as group

Quality

8.29

Promoting interoperability

100

Improvement activities

0

Cost

66.46

Merit-based Incentive Payment System (MIPS)

Final score

84.1 of 100Reported as group

Quality

64.8

Promoting interoperability

96

Improvement activities

40

Cost

68.87

Merit-based Incentive Payment System (MIPS)

Final score

89.98 of 100Reported as group

Quality

74.88

Promoting interoperability

96

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Acadia Hospital Corp

  • Psychiatric Hospital
  • Bangor, ME
  • NPI 1215940523
  Medicare reassignment Care Compare group NPD
• Eastern Maine Medical Center

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1790789147
  Medicare reassignment NPD
• Sebasticook Valley Health

  • Critical Access Hospital
  • Pittsfield, ME
  • NPI 1457461477
  Medicare reassignment NPD
• Eastern Maine Medical Center

  • Rehabilitation Hospital Unit
  • Bangor, ME
  • NPI 1780674689
  NPD
• Sebasticook Valley Health

  • Rural Health Clinic/Center
  • Unity, ME
  • NPI 1427181486
  NPD

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

• Eastern Maine Medical Center

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1790789147
  Care Compare affiliation
• Sebasticook Valley Health

  • Critical Access Hospital
  • Pittsfield, ME
  • NPI 1457461477
  Care Compare affiliation

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586131200000",
    "number": "1407876279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WHITING HILL RD STE 300",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121006",
            "telephone_number": "207-973-5035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 UNION ST STE 3",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013051",
            "telephone_number": "207-973-9980",
            "fax_number": "207-973-7515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTI-GALLANT",
        "first_name": "KATHLEEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SM0705X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Medical-Surgical",
            "state": "ME",
            "license": "CNP81358",
            "primary": true
        },
        {
            "code": "364SM0705X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Medical-Surgical",
            "state": "ME",
            "license": "R028705",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Rachel Forand, LCSW
• Christopher H Ford, DMD
• Renee Michelle Ford, PHARMD
• Samuel Richard Ford
• Lori A Forest, N.D.
• Kathleen M Fortier, LCPC
• Katharine J Disalvatore Fortin, MA
• Lisa B Foss, RN
• Suzanne Victoria Fougere, LCPC-C
• Chad Michael Fournier

• Medical-Surgical Clinical Nurse Specialist in Bangor, ME
• Providers in Bangor, ME by specialty
• Medical-Surgical Clinical Nurse Specialist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.