Active NPI
Brian J Gallagher, DO
- Vascular Surgery Physician
- Farmington, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- R8J31
- Practice address
- 1103 W Liberty St
Farmington, MO 63640-1921 - Phone
- (573) 756-6751
- Fax
- (573) 756-6807
- NPI assigned
- Aug 23, 2006
- Last updated
- Feb 11, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | R8J31 | MO | Primary |
Addresses
Primary practice location
1103 W Liberty St
Farmington, MO 63640-1921
Mailing address
1103 W Liberty St
Farmington, MO 63640-1921
Phone (573) 756-6751
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 247857105 | Medicaid | MO |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Vascular Surgery
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1101 W Liberty St
Farmington, MO 63640-1921
Phone (573) 756-6751
1103 W Liberty St
Farmington, MO 63640-1921
Phone (573) 756-6751
1110 Highlands Plaza Dr E
Saint Louis, MO 63110-1351
Phone (314) 273-0195
2630 Hwy K
O Fallon, MO 63368-6624
Phone (636) 240-5454
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 51 |
| Hernia repair - groin (open) | 1-10 |
| Pacemaker insertion or repair | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 23 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physician Groups LC | Vascular Surgery | Current | Accepting new patients |
| Physician Groups LC | Past | Accepting new patients |
Locations
1101 W Liberty St
Farmington, MO 63640
Phone (573) 705-1272
1103 W Liberty St
Farmington, MO 63640
Phone (573) 760-8488
2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454
670 Mason Ridge Center Dr
Ste 300
Saint Louis, MO 63141
Phone (314) 953-8250
969 N Mason Rd
Ste 160
Saint Louis, MO 63141
Phone (314) 434-8828
Interoperability endpoints
- bgallagher11086@direct.carenet.org
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1649299827
-
dba Parkland Health Center - Farmington
- General Acute Care Hospital
- Farmington, MO
- NPI 1003824061
-
dba Parkland Health Center - Farmington
- Psychiatric Hospital Unit
- Farmington, MO
- NPI 1902814866
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613001600000",
"number": "1639285356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1103 W LIBERTY ST",
"city": "FARMINGTON",
"state": "MO",
"postal_code": "636401921",
"telephone_number": "573-756-6751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1103 W LIBERTY ST",
"city": "FARMINGTON",
"state": "MO",
"postal_code": "636401921",
"telephone_number": "573-756-6751",
"fax_number": "573-756-6807"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALLAGHER",
"first_name": "BRIAN",
"middle_name": "J",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-23",
"last_updated": "2021-02-11",
"certification_date": "2021-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "MO",
"license": "R8J31",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "247857105",
"state": "MO"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "BJC",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1103 W Liberty St",
"city": "Farmington",
"state": "MO",
"country_code": "US",
"postal_code": "636401921",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Farmington, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.