Individual provider Active NPI

Carlene A. Campbell Gal, RPA-C

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1881605657
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
009687 Issued in NY
Practice address
150 55TH St
Brooklyn, NY 11220-2508
Phone
(718) 630-6745
NPI assigned
Aug 10, 2006
Last updated
Aug 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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 009687 NY Primary

Addresses

Primary practice location

150 55TH St
Brooklyn, NY 11220-2508

Mailing address

90 Park Ter E
Apartment 7a
New York, NY 10034-1427
Phone (212) 567-6740

Other practice location 1

1065 Southern Blvd
Bronx, NY 10459-2417
Phone (718) 589-2440

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ccampbellgal128161@nyumc.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20081106000741 NY Practitioner - Physician Assistant 5890854780 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Lij Urgent Care PCGroup PAC ID 6002131778, 389 clinicians

Practice addresses (Care Compare)

1555 1St Ave
New York, NY 10028-3903
Phone (212) 897-1991

199 Amsterdam Ave
New York, NY 10023-5024
Phone (646) 863-0463

377 S Oyster Bay Rd
Plainview, NY 11803-3323
Phone (516) 537-9061

5505 Myrtle Ave
Ridgewood, NY 11385-3550
Phone (718) 502-9063

5828 99TH St
Corona, NY 11368-4306
Phone (718) 502-9867

5828 99TH St Corona
Corona, NY 11368-4306
Phone (718) 502-9867

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
009687NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Aug 1, 2016 Accepting new patients
Nes Medical Services of New York PC CurrentSince Apr 1, 2011 Accepting new patients
New York University CurrentSince Aug 1, 2016 Accepting new patients

Locations

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7123

Interoperability endpoints

  • Direct secure messaging: carlene.campbell@ghuc.eclinicaldirectplus.com
  • Direct secure messaging: ccampbellgal128161@nyumc.direct-ci.com

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, 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": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1881605657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 PARK TER E",
            "address_2": "APARTMENT 7A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100341427",
            "telephone_number": "212-567-6740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 55TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112202508",
            "telephone_number": "718-630-6745"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1065 Southern Blvd",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104592417",
            "country_code": "US",
            "telephone_number": "718-589-2440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL GAL",
        "first_name": "CARLENE",
        "middle_name": "A.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "009687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccampbellgal128161@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "150 55th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112202508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.