Active NPI
Victoria Gallardo-Navarra, M.D.
- Surgery Physician
- Bloomfield Hills, MI
National Provider Identifier
1801874672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 33538
- Practice address
- 2898 Colonial TRL
Bloomfield Hills, MI 48304-1618 - Phone
- (248) 762-6322
- Fax
- (248) 334-2868
- NPI assigned
- Jan 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 33538 | MI | Primary |
| Surgery Physician | 208600000X | 3509365 | OH |
Addresses
Primary practice location
2898 Colonial TRL
Bloomfield Hills, MI 48304-1618
Mailing address
2898 Colonial TRL
Bloomfield Hills, MI 48304-1618
Phone (248) 762-6322
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 107439510 | Medicaid | OH | |
| 10-1074395 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33538 | MI | MD | Surgery Physician |
| 3509365 | OH | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Openloop Healthcare Partners PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Physician
- Des Moines, IA
- NPI 1245820661
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429833600000",
"number": "1801874672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2898 COLONIAL TRL",
"city": "BLOOMFIELD HILLS",
"state": "MI",
"postal_code": "483041618",
"telephone_number": "248-762-6322",
"fax_number": "248-334-2868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2898 COLONIAL TRL",
"city": "BLOOMFIELD HILLS",
"state": "MI",
"postal_code": "483041618",
"telephone_number": "248-762-6322",
"fax_number": "248-334-2868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALLARDO-NAVARRA",
"first_name": "VICTORIA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-03",
"last_updated": "2015-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MI",
"license": "33538",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "OH",
"license": "3509365",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "107439510",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10-1074395",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bloomfield Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.