Mary Catherine Gallagher

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

159 Cross Bay Blvd
21
Howard Beach, NY 11414

Phone

(718) 641-7575

NPI assigned

Jan 10, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Atlantic Dermatologic Associates, LLPGroup PAC ID 8022900869, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Atlantic Dermatologic Associates, LLP

  • Specialist
  • Lynbrook, NY
  • NPI 1447264387
  Medicare reassignment Care Compare group
• Atlantic Dermatologic Associates, LLP

  • Specialist
  • Brooklyn, NY
  • NPI 1922274182
  NPD (past)

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

{
    "created_epoch": "1673308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1457065997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 CROSS BAY BLVD",
            "address_2": "21",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "11414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 CROSS BAY BLVD",
            "address_2": "21",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "11414",
            "telephone_number": "718-641-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "MARY",
        "middle_name": "CATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-10",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Skyy Fulcher, RN
• Functional Wellness Medical Care PLLC
• Jennifer Ann Furno
• Stephanie Nicole Gabriel, FNP
• Gabriella Gaitan
• Concetta Gallo, LMFT
• Maryann Gallucci, M.S., R.D.,C.D.N.
• Purvi Amit Gandhi, M.A.CCC-SLP
• Rebecca Alea Gazze, AU.D., CCC-A
• Emmanuel Gelin, MD

• Physician Assistant in Howard Beach, NY
• Providers in Howard Beach, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.
• 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.