Individual provider Active NPI

Robert Michael Galbraith, D.O.

  • Sports Medicine (Family Medicine) Physician
  • Tyler, TX
National Provider Identifier
1609802859
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
S9506 Issued in TX
Practice address
3310 Patriot Dr
Tyler, TX 75701-6606
Phone
(039) 877-7200
Fax
(903) 939-7878
NPI assigned
Jun 22, 2006
Last updated
Apr 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X S9506 TX
Family Medicine Physician 207Q00000X 11013077A IN
Sports Medicine (Family Medicine) Physician 207QS0010X S9506 TX Primary

Addresses

Primary practice location

3310 Patriot Dr
Tyler, TX 75701-6606

Mailing address

11937 US Highway 271
Tyler, TX 75708-3154
Phone (903) 877-7200

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
I20210427000269 TX Practitioner - Sports MedicinePractitioner - Family Practice 4284719386 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Family Practice
Education
Arizona College of Osteopathic Medicine Mid Western University, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ault McInnis PLLCGroup PAC ID 9133396674, 7 clinicians

Practice addresses (Care Compare)

2114 E Rusk St
Jacksonville, TX 75766-9052
Phone (903) 284-6105

2116 E Rusk St
Jacksonville, TX 75766-9052

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11013077AINMDFamily Medicine Physician
S9506TXMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Health Science Center at Tyler-Facility-Physician CurrentSince Feb 1, 2021 Accepting new patients
Etmc Physician Group Inc. CurrentSince Sep 1, 2021 Accepting new patients
Etmc Physician Group Inc. CurrentSince Sep 1, 2021 Accepting new patients
University of Texas Health Science Center at Tyler-Facilty-Physician CurrentSince Feb 1, 2021 Accepting new patients
Ault McInnis PLLC Family Medicine CurrentSince Feb 6, 2024 Accepting new patients
Memorial Hospital of South Bend Past Accepting new patients

Locations

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

2114 E Rusk St
Jacksonville, TX 75766
Phone (903) 284-6105

102 W Henderson St
Overton, TX 75684
Phone (903) 834-0201

11937 US Highway 271
Tyler, TX 75708
Phone (903) 877-3451

3310 Patriot Dr
Tyler, TX 75701
Phone (903) 877-8925

Organizations & group practices 6

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 2

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1609802859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11937 US HIGHWAY 271",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757083154",
            "telephone_number": "903-877-7200",
            "fax_number": "903-939-7878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 PATRIOT DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757016606",
            "telephone_number": "039-877-7200",
            "fax_number": "903-939-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALBRAITH",
        "first_name": "ROBERT",
        "middle_name": "MICHAEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "S9506",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11013077A",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "TX",
            "license": "S9506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.