Individual provider Active NPI

Michael Gallagher, P.T.

  • Physical Therapist
  • Rockland, ME
National Provider Identifier
1619176609
Registry record updated Feb 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT2630 Issued in ME
Practice address
91 Camden St.
Suite 401
Rockland, ME 04841-2421
Phone
(207) 593-6682
Fax
(207) 213-1075
NPI assigned
Jul 11, 2007
Last updated
Feb 6, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT2630 ME Primary

Addresses

Primary practice location

91 Camden St.
Suite 401
Rockland, ME 04841-2421

Mailing address

91 Camden St.
Suite 401
Rockland, ME 04841-2421
Phone (207) 593-6682

Other identifiers 2

IdentifierTypeStateIssuer
11802105OtherMECAQH
9772088OtherMEAETNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070907000582 ME Practitioner - Physical Therapist in Private Practice 8426141367 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Reform Physical Therapy, Inc Physical Therapist CurrentSince Dec 1, 2023 Accepting new patients
Rivertree Osteopathic Health PC Past Accepting new patients
Gallagher Rehab and Wellness,Inc Physical Therapist Past Accepting new patients
Continuum Physical Therapy PA Physical Therapist PastSince Jun 11, 2009 Accepting new patients

Locations

190 Pleasant St
Brunswick, ME 04011

23 Durham Rd
Ste 101
Freeport, ME 04032
Phone (207) 725-4400

525 Main St
Ste C
South Portland, ME 04106
Phone (207) 274-6245

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360108800000",
    "number": "1619176609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 CAMDEN ST.",
            "address_2": "SUITE 401",
            "city": "ROCKLAND",
            "state": "ME",
            "postal_code": "048412421",
            "telephone_number": "207-593-6682",
            "fax_number": "207-213-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 CAMDEN ST.",
            "address_2": "SUITE 401",
            "city": "ROCKLAND",
            "state": "ME",
            "postal_code": "048412421",
            "telephone_number": "207-593-6682",
            "fax_number": "207-213-1075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "MICHAEL",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-11",
        "last_updated": "2013-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT2630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11802105",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9772088",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.