Lisa Marie Gallo, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

081024-23 Issued in NH

Practice address

275 Mammoth Rd Ste 3
Manchester, NH 03109-4133

Phone

(603) 663-8400

Fax

(603) 663-8400

NPI assigned

Aug 9, 2021

Last updated

Apr 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lisa Marie Costello Former name

Medicare fee-for-service enrollment

Enrolled in NH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Nashua, NH
  • NPI 1851082291
  Medicare reassignment NPD
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Plaistow, NH
  • NPI 1730870171
  NPD
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Sturbridge, MA
  • NPI 1386526192
  NPD
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Bedford, NH
  • NPI 1154012573
  NPD (past)
• Convenientmd LLC

  • Urgent Care Clinic/Center
  • Bedford, NH
  • NPI 1629477021
  NPD (past)
• Derry Medical Center, PA

  • Family Medicine Physician
  • Derry, NH
  • NPI 1922030493
  NPD (past)
• Elliot Hospital

  • General Acute Care Hospital
  • Manchester, NH
  • NPI 1508080391
  NPD (past)

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

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1679247076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 MAMMOTH RD STE 3",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031094133",
            "telephone_number": "603-663-8400",
            "fax_number": "603-663-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 MAMMOTH RD STE 3",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031094133",
            "telephone_number": "603-663-8400",
            "fax_number": "603-663-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLO",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-09",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "081024-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "COSTELLO",
            "middle_name": "MARIE",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jillian Gallagher, LNA
• Joan C Gallagher, LCMHC
• Scott Gallagher
• Rebecca Jeanne Gallant, APRN
• Valerie Gallicchio, LICSW
• Shirley V Galucki, MD
• James Gamache, MSW, MLADC, ICAADC
• Lisa Gamache, PTA
• Madeleine Mary Gamache, PA-C
• Rosamunde Gammad, MA

• Family Nurse Practitioner in Manchester, NH
• Providers in Manchester, NH by specialty
• Family Nurse Practitioner in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.