Elizabeth Denise Gallegos, M.D.

Primary specialty

Nuclear Medicine PhysicianTaxonomy code 207U00000X

License

13364R Issued in LA

Practice address

5000 Hennessy Blvd
Baton Rouge, LA 70808-4375

Phone

(225) 769-9797

Fax

(225) 769-4228

NPI assigned

Sep 25, 2006

Last updated

Apr 21, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Elizabeth Denise Gallegos-Farhat Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Nuclear Imaging LLC

  dba PET Imaging at the Lake

  • Nuclear Medicine Physician
  • Baton Rouge, LA
  • NPI 1417047796
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303344000000",
    "number": "1477653673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 HENNESSY BLVD",
            "address_2": "SUITE 110",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084300",
            "telephone_number": "225-769-7979",
            "fax_number": "225-769-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 HENNESSY BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084375",
            "telephone_number": "225-769-9797",
            "fax_number": "225-769-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLEGOS",
        "first_name": "ELIZABETH",
        "middle_name": "DENISE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2011-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G069197",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0070878",
            "primary": false
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "LA",
            "license": "13364R",
            "primary": true
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "MS",
            "license": "16977",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1568741",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "GALLEGOS-FARHAT",
            "middle_name": "DENISE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashley Gaitan
• Maya B Galathe, LPC
• Jacqueline Lee Gales
• Emily Parrill Galjour
• Holley Galland, M.D.,MPH
• Stephanie Lizette Gallegos
• Alexander August Galliano, DDS
• Carol J. Galliano, D.D.S.
• Lacey Galliano, D.D.S.
• Sydney Nicole Galtney

• Nuclear Medicine Physician in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Nuclear Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.