Individual provider Active NPI

Michelle Phyllis Gallant, MS, RDN, LDN

  • Registered Dietitian
  • Cambridge, MA
National Provider Identifier
1730286352
Registry record updated Sep 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2777 Issued in MA
Practice address
75 Mount Auburn St
Harvard University Health Services
Cambridge, MA 02138-4960
Phone
(617) 495-1487
Fax
(617) 496-0540
NPI assigned
Sep 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 2777 MA Primary

Addresses

Primary practice location

75 Mount Auburn St
Harvard University Health Services
Cambridge, MA 02138-4960

Mailing address

75 Mount Auburn St
Harvard University Health Services
Cambridge, MA 02138-4960
Phone (617) 495-1487

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081103000447 MA Practitioner - Registered Dietitian Or Nutrition Professional 7719977487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
President and Fellows of Harvard CollegeGroup PAC ID 2062303894, 94 clinicians

Practice addresses (Care Compare)

1563 Mass Ave
Cambridge, MA 02138-2903
Phone (617) 495-4414

75 Mount Auburn St
Cambridge, MA 02138-4960
Phone (617) 496-8700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
001401NYMDMental Health Counselor
2777MAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
President and Fellows of Harvard College CurrentSince Sep 22, 2008 Accepting new patients
President & Fellows of Harvard College CurrentSince Sep 22, 2008 Accepting new patients

Locations

188 Longwood Ave
Boston, MA 02115
Phone (617) 432-1434

75 Mount Auburn St
Cambridge, MA 02138
Phone (617) 495-2042

75 Mount Auburn St
#H
Cambridge, MA 02138
Phone (617) 495-4414

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473811200000",
    "number": "1730286352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 MOUNT AUBURN ST",
            "address_2": "HARVARD UNIVERSITY HEALTH SERVICES",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384960",
            "telephone_number": "617-495-1487",
            "fax_number": "617-496-0540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 MOUNT AUBURN ST",
            "address_2": "HARVARD UNIVERSITY HEALTH SERVICES",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384960",
            "telephone_number": "617-495-1487",
            "fax_number": "617-496-0540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLANT",
        "first_name": "MICHELLE",
        "middle_name": "PHYLLIS",
        "name_prefix": "Ms.",
        "credential": "MS, RDN, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2016-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "2777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.