Individual provider Active NPI

Rocky Dominic Gallamoza, CRNP

  • Family Nurse Practitioner
  • Frederick, MD
National Provider Identifier
1487248548
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R180601 Issued in MD
Practice address
300 Ballenger Center Dr
Frederick, MD 21703-7096
Phone
(301) 682-7213
NPI assigned
Mar 1, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R180601 MD Primary

Addresses

Primary practice location

300 Ballenger Center Dr
Frederick, MD 21703-7096

Mailing address

300 Ballenger Center Dr
Frederick, MD 21703-7096
Phone (301) 682-7213

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20210512001441 MD Practitioner - Nurse Practitioner 0345659967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Walnut Street Community Health Center, Inc.Group PAC ID 6305757402, shared by 2 NPIs, 18 clinicians

Practice addresses (Care Compare)

201 S Cleveland Ave
Hagerstown, MD 21740-5745
Phone (301) 745-3777

Merit-based Incentive Payment System (MIPS)

Final score
77.37 of 100Reported as group
Quality
74
Improvement activities
40
Cost
72.24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Walnut Street Community Health Center, Inc. CurrentSince Sep 16, 2024 Accepting new patients
Walnut Street Community Health Center, Inc. CurrentSince Sep 16, 2024 Accepting new patients

Locations

201 S Cleveland Ave
Hagerstown, MD 21740
Phone (301) 745-3777

Interoperability endpoints

  • Direct secure messaging: rocky.gallamoza.1@30195.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1487248548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 BALLENGER CENTER DR",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217037096",
            "telephone_number": "301-682-7213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BALLENGER CENTER DR",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217037096",
            "telephone_number": "301-682-7213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAMOZA",
        "first_name": "ROCKY",
        "middle_name": "DOMINIC",
        "name_prefix": "Mr.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-01",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R180601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.