NPIMap

Individual provider Active NPI

Timothy Michael Gallagher, M.D.

  • Anesthesiology Physician
  • Las Vegas, NV
National Provider Identifier
1700953452
Registry record updated Jan 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
15573 Issued in NV
Practice address
2450 W Charleston Blvd
Las Vegas, NV 89102-2179
Phone
(702) 877-8661
Fax
(702) 877-5140
NPI assigned
Nov 29, 2006
Last updated
Jan 13, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD.022259 LA
Anesthesiology Physician 207L00000X 15573 NV Primary

Addresses

Primary practice location

2450 W Charleston Blvd
Las Vegas, NV 89102-2179

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 877-8661

Other identifiers 2

IdentifierTypeStateIssuer
1676080MedicaidLA
1700953452MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20141229002264 NV Practitioner - Anesthesiology 3072796036 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Louisiana State University School of Medicine in New Orleans, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Red Rock Anesthesia Consultants LLCGroup PAC ID 4284910290, 109 clinicians

Practice addresses (Care Compare)

5400 S Rainbow Blvd
Las Vegas, NV 89118-1859
Phone (702) 325-4651

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.022259LAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Group Rhodes P C CurrentSince Dec 1, 2019 Accepting new patients
Optum Medical Group Rhodes P C CurrentSince Dec 1, 2019 Accepting new patients
Red Rock Anesthesia Consultants LLC Anesthesiology CurrentSince Apr 1, 2020 Accepting new patients
Optum Medical Group Rhodes P C Anesthesiology Current Accepting new patients
Optum Medical Group II Rhodes P C CurrentSince Jan 26, 2015 Accepting new patients
The Spine Management Center,LLC Past Accepting new patients
A. Waring, LLC Past Accepting new patients

Locations

58 N Pecos Rd
Henderson, NV 89074
Phone (702) 822-2000

2450 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 877-8660

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

5400 S Rainbow Blvd
Las Vegas, NV 89118
Phone (702) 252-7342

Organizations & group practices 7

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 7

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484265600000",
    "number": "1700953452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-877-8661",
            "fax_number": "702-877-5140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022179",
            "telephone_number": "702-877-8661",
            "fax_number": "702-877-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "TIMOTHY",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2017-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "LA",
            "license": "MD.022259",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NV",
            "license": "15573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1676080",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700953452",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.