Active NPI
Michaela C Gallagher-Gonzales, PA-C
- Medical Physician Assistant
- Santa Fe, NM
National Provider Identifier
1407904832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- NM 94 PA 34
- Practice address
- 2212 Brothers Rd
Santa Fe, NM 87505-6903 - Phone
- (502) 983-9460
- Fax
- (505) 983-0568
- NPI assigned
- Jan 8, 2007
- Last updated
- Mar 7, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | NM 94 PA 34 | NM | Primary |
Addresses
Primary practice location
2212 Brothers Rd
Santa Fe, NM 87505-6903
Mailing address
1923 Kiva Rd
Santa Fe, NM 87505-3314
Phone (505) 983-2980
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NM 94 PA 34 | Other | NM | MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NM 94 PA 34 | NM | MD | Medical Physician Assistant |
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1407904832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1923 KIVA RD",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875053314",
"telephone_number": "505-983-2980",
"fax_number": "505-983-2980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2212 BROTHERS RD",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875056903",
"telephone_number": "502-983-9460",
"fax_number": "505-983-0568"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALLAGHER-GONZALES",
"first_name": "MICHAELA",
"middle_name": "C",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-08",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NM",
"license": "NM 94 PA 34",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "NM 94 PA 34",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.