NPIMap

Individual provider Active NPI

Benjamin Galloway, DPM

  • Foot & Ankle Surgery Podiatrist
  • Chicago, IL
National Provider Identifier
1568088706
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
135.001080 Issued in IL
Practice address
820 S Damen Ave
Chicago, IL 60612-3728
Phone
(312) 569-8387
NPI assigned
Jun 23, 2020
Last updated
Mar 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 118648 MT
Foot & Ankle Surgery Podiatrist 213ES0103X 135.001080 IL Primary

Addresses

Primary practice location

820 S Damen Ave
Chicago, IL 60612-3728

Mailing address

50 E 16TH St Unit 1213
Chicago, IL 60616-5145
Phone (406) 581-8056

Other practice location 1

2825 Stockyard Rd Ste J1
Missoula, MT 59808-1548
Phone (406) 581-8056

Other practice location 2

106 S 2nd St
Hamilton, MT 59840-2517
Phone (406) 581-8056

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230703002865 MT Practitioner - Podiatry 9537528963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Montana Foot and Ankle PLLCGroup PAC ID 6002176302, 3 clinicians

Practice addresses (Care Compare)

2825 Stockyard Rd
Suite J1
Missoula, MT 59808-1548
Phone (406) 543-5333

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue128
Removal of skin lesions1-10
Removal of nail tissue711
Removal or shaving of skin growth237

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
135.001080ILMDFoot & Ankle Surgery Podiatrist
118648MTMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Western Montana Foot and Ankle PLLC Foot & Ankle Surgery CurrentSince Jul 1, 2023 Accepting new patients

Locations

2825 Stockyard Rd
Ste J1
Missoula, MT 59808
Phone (406) 543-5333

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 6

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": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1568088706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 E 16TH ST UNIT 1213",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606165145",
            "telephone_number": "406-581-8056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123728",
            "telephone_number": "312-569-8387"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2825 Stockyard Rd Ste J1",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598081548",
            "country_code": "US",
            "telephone_number": "406-581-8056",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "106 S 2nd St",
            "address_purpose": "LOCATION",
            "city": "Hamilton",
            "state": "MT",
            "postal_code": "598402517",
            "country_code": "US",
            "telephone_number": "406-581-8056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLOWAY",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-23",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MT",
            "license": "118648",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "135.001080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.