Individual provider Active NPI

Michael R Gallina, DPM

  • Foot & Ankle Surgery Podiatrist
  • Venice, FL
National Provider Identifier
1841279486
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO3070 Issued in FL
Practice address
435 Commercial CT
Venice, FL 34292-1658
Phone
(941) 559-0262
Fax
(941) 375-8569
NPI assigned
Jan 12, 2006
Last updated
Mar 27, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PO3070 FL Primary

Addresses

Primary practice location

435 Commercial CT
Venice, FL 34292-1658

Mailing address

425 Nursing Home Dr
Arcadia, FL 34266-3839
Phone (863) 993-2966

Other identifiers 1

IdentifierTypeStateIssuer
PO3070OtherFLFLORIDA LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031117000186 FL Practitioner - Podiatry 0042124828 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

836 Sunset Lake Blvd
Suite 102
Venice, FL 34292-7555
Phone (941) 497-1771

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO3070FLMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Orthopedic Center of Charlotte County, PA CurrentSince Feb 1, 2025 Accepting new patients
Advanced Orthopedic Center of Charlotte County, PA CurrentSince Feb 1, 2025 Accepting new patients
Arcadia Medical Associates PA CurrentSince Dec 1, 2022 Accepting new patients
Arcadia Medical Associates PA Foot & Ankle Surgery CurrentSince Dec 1, 2022 Accepting new patients
Leading Edge Physical Therapy & Sports, Inc. PastSince Jun 2, 2004 Accepting new patients
Podiatry Associates of Venice and Englewood Foot & Ankle Surgery Past Accepting new patients
Southern Ohio Foot and Ankle Associates Inc Past Accepting new patients

Locations

425 Nursing Home Dr
Arcadia, FL 34266
Phone (863) 494-9991

1641 Tamiami Trl
Ste 1
Pt Charlotte, FL 33948
Phone (941) 629-6262

435 Commercial Ct
Venice, FL 34292
Phone (941) 484-2602

836 Sunset Lake Blvd
Ste 102
Venice, FL 34292
Phone (941) 497-1771

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1841279486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 NURSING HOME DR",
            "city": "ARCADIA",
            "state": "FL",
            "postal_code": "342663839",
            "telephone_number": "863-993-2966",
            "fax_number": "863-494-5491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 COMMERCIAL CT",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342921658",
            "telephone_number": "941-559-0262",
            "fax_number": "941-375-8569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLINA",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO3070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA LICENSE NUMBER",
            "identifier": "PO3070",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

Verify at the official NPI Registry.