Individual provider Active NPI

Michael James Gagliardo, MD

  • Family Medicine Physician
  • Clifton Heights, PA
National Provider Identifier
1407988843
Registry record updated Nov 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD035945E Issued in PA
Practice address
201 West Brook Dr
Clifton Heights, PA 19018
Phone
(610) 623-0600
Fax
(610) 623-0970
NPI assigned
Mar 12, 2007
Last updated
Nov 27, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD035945E PA Primary

Addresses

Primary practice location

201 West Brook Dr
Clifton Heights, PA 19018

Mailing address

201 West Brook Drive
Clifton Heights, PA 19018
Phone (610) 623-0600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071220000476 PA Practitioner - Family Practice 3375633852 Practice locations: Clifton Heights, PA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novacare Outpatient Rehabilitation East, Inc.Group PAC ID 3678480290, shared by 15 NPIs, 493 clinicians

Practice addresses (Care Compare)

201 2ND Ave
Collegeville, PA 19426-3613
Phone (610) 489-7703

201 Westbrook Dr
Clifton Heights, PA 19018-1116
Phone (610) 623-0600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD035945EPAMDFamily Medicine Physician

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196121600000",
    "number": "1407988843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 WEST BROOK DRIVE",
            "city": "CLIFTON HEIGHTS",
            "state": "PA",
            "postal_code": "19018",
            "telephone_number": "610-623-0600",
            "fax_number": "610-623-0970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 WEST BROOK DR",
            "city": "CLIFTON HEIGHTS",
            "state": "PA",
            "postal_code": "19018",
            "telephone_number": "610-623-0600",
            "fax_number": "610-623-0970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGLIARDO",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD035945E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton Heights, PA

Sources for this page

Verify at the official NPI Registry.