Individual provider Active NPI

Jennifer Jade Gallegos, M.D.

  • Anesthesiology Physician
  • San Antonio, TX
National Provider Identifier
1457671067
Registry record updated May 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
P9571 Issued in TX
Practice address
4242 Medical Dr
Suite 3100
San Antonio, TX 78229-5640
Phone
(210) 615-1187
Fax
(210) 614-2180
NPI assigned
Jun 4, 2010
Last updated
May 19, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X BP10036716 TX
Anesthesiology Physician 207L00000X P9571 TX Primary

Addresses

Primary practice location

4242 Medical Dr
Suite 3100
San Antonio, TX 78229-5640

Mailing address

PO Box 34717
San Antonio, TX 78265-4717
Phone (210) 615-1187

Other identifiers 1

IdentifierTypeStateIssuer
3402984-01MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20141022000913 TX Practitioner - Anesthesiology 2961623665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allen Anesthesia AssociatesGroup PAC ID 2264477140, 94 clinicians

Practice addresses (Care Compare)

4510 Medical Ctr Dr
Suite 150
McKinney, TX 75069-0144
Phone (972) 547-1580

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10036716TXMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allen Anesthesia Associates CurrentSince Oct 23, 2023 Accepting new patients

Locations

1105 Central Expy N
Ste 210
Allen, TX 75013
Phone (972) 747-4646

906 W McDermott Dr
Allen, TX 75013
Phone (918) 812-4755

4401 Coit Rd
Ste 100
Frisco, TX 75035
Phone (214) 619-0120

4510 Medical Center Dr
Ste 150
McKinney, TX 75069
Phone (972) 547-1580

4510 Medical Center Dr
Ste 211
McKinney, TX 75069
Phone (469) 541-1600

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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": "1275609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431993600000",
    "number": "1457671067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34717",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782654717",
            "telephone_number": "210-615-1187",
            "fax_number": "210-614-2180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4242 MEDICAL DR",
            "address_2": "SUITE 3100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782295640",
            "telephone_number": "210-615-1187",
            "fax_number": "210-614-2180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLEGOS",
        "first_name": "JENNIFER",
        "middle_name": "JADE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-04",
        "last_updated": "2015-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "BP10036716",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "P9571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3402984-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.