Organization Active NPI

Ruth K Gallatin, MD PA

  • Internal Medicine Physician
  • Gambrills, MD
National Provider Identifier
1417928623
Registry record updated Apr 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
RUTH K GALLATIN, MD PA
Practice address
2401 Brandermill Blvd
Suite 220
Gambrills, MD 21054-1690
Phone
(410) 451-7214
Fax
(410) 451-7218
NPI assigned
Jan 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2019

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

Authorized official

Name
Dr. Ruth K Gallatin, MDNPI 1598758054
Title
Physicians/Owner
Phone
(410) 451-7214

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2401 Brandermill Blvd
Suite 220
Gambrills, MD 21054-1690

Mailing address

2401 Brandermill Blvd Ste 220
Gambrills, MD 21054-1692
Phone (410) 451-7214

Other identifiers 3

IdentifierTypeStateIssuer
405070300MedicaidMD
0G80RKOtherBCBS
F138OtherBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041018000088 MD Part B Supplier - Clinic/Group Practice 1355301037 Receives reassigned benefits from 1 practitioner
Practice locations: Gambrills, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556236800000",
    "number": "1417928623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 BRANDERMILL BLVD STE 220",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541692",
            "telephone_number": "410-451-7214",
            "fax_number": "410-451-7218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 BRANDERMILL BLVD",
            "address_2": "SUITE 220",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541690",
            "telephone_number": "410-451-7214",
            "fax_number": "410-451-7218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUTH K GALLATIN, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-27",
        "last_updated": "2019-04-26",
        "status": "A",
        "authorized_official_last_name": "GALLATIN",
        "authorized_official_first_name": "RUTH",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PHYSICIANS/OWNER",
        "authorized_official_telephone_number": "410-451-7214",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405070300",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0G80RK",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "F138",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gambrills, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.