Individual provider Active NPI

Aida Karen Gallagher, PA-C

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1730324013
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA 053772 Issued in PA
Practice address
401-55 West Allegheny Avenue
Philadelphia, PA 19133-3644
Phone
(215) 291-2500
Fax
(215) 291-2587
NPI assigned
Dec 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA 053772 PA Primary

Addresses

Primary practice location

401-55 West Allegheny Avenue
Philadelphia, PA 19133-3644

Mailing address

1412 Fairmount Ave
Philadelphia, PA 19130-2908
Phone (215) 599-4851

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aida.gallagher@direct.dvch.nextgenshare.com Health Information Exchange (HIE)

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20121015000261 PA Practitioner - Physician Assistant 1052586203 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA 053772PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Delaware Valley Community Health, Inc. CurrentSince Aug 15, 2012 Accepting new patients
Delaware Valley Community Health, Inc. CurrentSince Aug 15, 2012 Accepting new patients

Locations

1412 Fairmount Ave
Philadelphia, PA 19130
Phone (215) 235-9600

Interoperability endpoints

  • Direct secure messaging: aida.gallagher@direct.dvch.nextgenshare.com

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": "1229299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1730324013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 FAIRMOUNT AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191302908",
            "telephone_number": "215-599-4851",
            "fax_number": "214-232-4093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401-55 WEST ALLEGHENY AVENUE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191333644",
            "telephone_number": "215-291-2500",
            "fax_number": "215-291-2587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "AIDA",
        "middle_name": "KAREN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-15",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA 053772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aida.gallagher@direct.dvch.nextgenshare.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "401-55 West Allegheny Avenue",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191333644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.