NPIMap

Individual provider Active NPI

Anthony James Gallo, MD

  • Diagnostic Radiology Physician
  • Pikeville, KY
National Provider Identifier
1811217375
Registry record updated May 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
46405 Issued in KY
Practice address
161 College St Ste 1
Rad: Diagnostic
Pikeville, KY 41501-4786
Phone
(606) 432-1357
Fax
(606) 432-2457
NPI assigned
Jun 8, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 46405 KY Primary

Addresses

Primary practice location

161 College St Ste 1
Rad: Diagnostic
Pikeville, KY 41501-4786

Mailing address

PO Box 2648
Rad: Diagnostic
Pikeville, KY 41502
Phone (606) 432-1357

Other identifiers 7

IdentifierTypeStateIssuer
2014248664MedicaidVA
7100297390OtherKYKENTUCKY MEDICAID
986408OtherKYWELLCARE OF KENTUCKY
304018OtherKYCOVENTRY
3810028087OtherWVMOLINA WEST VA MAA
000000872442OtherKYANTHEM
P01342718OtherKYPALMETTO GBA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20150909003404 AZ Practitioner - Diagnostic Radiology 3476791450 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Arizona Radiology P CGroup PAC ID 4880683085, 20 clinicians

Practice addresses (Care Compare)

77 W Forest Ave
Suite 101
Flagstaff, AZ 86001-1482
Phone (928) 773-2515

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Arizona Radiology P C Diagnostic Radiology CurrentSince Aug 1, 2015 Accepting new patients
Alliance Healthcare Services Inc. CurrentSince Oct 23, 2015 Accepting new patients
Pikeville Radiology Diagnostic Radiology Past Accepting new patients

Locations

1298 W Finnie Flat Rd
Camp Verde, AZ 86322
Phone (928) 639-5509

269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251

450 S Willard St
Ste 111
Cottonwood, AZ 86326
Phone (928) 639-6587

1485 N Turquoise Dr
Flagstaff, AZ 86001
Phone (928) 774-6626

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

77 W Forest Ave
Ste 102
Flagstaff, AZ 86001

77 W Forest Ave
Ste 101
Flagstaff, AZ 86001
Phone (928) 773-2215

3700 W State Route 89A
Sedona, AZ 86336
Phone (928) 204-3000

301 S 7th St
Williams, AZ 86046
Phone (928) 380-2611

1501 N Williamson Ave
Winslow, AZ 86047
Phone (928) 289-4691

Organizations & group practices 4

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 12

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": "1275955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431302400000",
    "number": "1811217375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2648",
            "address_2": "RAD: DIAGNOSTIC",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "41502",
            "telephone_number": "606-432-1357",
            "fax_number": "606-432-2457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 COLLEGE ST STE 1",
            "address_2": "RAD: DIAGNOSTIC",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415014786",
            "telephone_number": "606-432-1357",
            "fax_number": "606-432-2457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLO",
        "first_name": "ANTHONY",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-08",
        "last_updated": "2015-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KY",
            "license": "46405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2014248664",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENTUCKY MEDICAID",
            "identifier": "7100297390",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE OF KENTUCKY",
            "identifier": "986408",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "304018",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA WEST VA MAA",
            "identifier": "3810028087",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000872442",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "P01342718",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pikeville, KY

Sources for this page

Verify at the official NPI Registry.