Individual provider Active NPI

Kristin Gallagher, PA-C

  • Physician Assistant
  • Portland, ME
National Provider Identifier
1790411031
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2287 Issued in ME
Practice address
22 Bramhall St
Portland, ME 04102-3175
Phone
(207) 662-0111
NPI assigned
Jul 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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 PA2287 ME Primary

Addresses

Primary practice location

22 Bramhall St
Portland, ME 04102-3175

Mailing address

887 Congress St Ste 400
Portland, ME 04102-3163
Phone (207) 774-6368

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20230405000174 ME Practitioner - Physician Assistant 6709251705 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

Hospital & facility affiliations

  • Mainehealth Maine Medical Center Hospital, Portland, ME, CCN 200009

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA2287MEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Apr 3, 2023 Accepting new patients
Mainehealth CurrentSince Apr 3, 2023 Accepting new patients
Maine Medical Partners CurrentSince Apr 3, 2023 Accepting new patients
Mainehealth Past Accepting new patients

Locations

887 Congress St
Ste 400
Portland, ME 04102
Phone (207) 774-6368

887 Congress St
Ste 210
Portland, ME 04102
Phone (207) 774-2381

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

22 Bramhall St
#B
Portland, ME 04102

Interoperability endpoints

  • Direct secure messaging: kgallagher361038@direct.mmc.mainehealth.org

Organizations & group practices 6

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.

Hospital & facility affiliations 36

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1658966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1790411031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "887 CONGRESS ST STE 400",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023163",
            "telephone_number": "207-774-6368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023175",
            "telephone_number": "207-662-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "KRISTIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-28",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA2287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.