Laureen Ann Gallo, CRNP MSN is a medicare enrolled "Nurse Practitioner" physician in Salisbury, Maryland. Her current practice location is
400 Eastern Shore Dr Ste 204, Salisbury, Maryland. You can reach out to her office (for appointments etc.) via phone at
(410) 912-6716.
Laureen Ann Gallo is licensed to practice in Maryland (license number AC000295) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1740251305.
Physician's Profile
| Full Name | Laureen Ann Gallo |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Location | 400 Eastern Shore Dr Ste 204, Salisbury, Maryland |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1740251305
- Provider Enumeration Date: 01/31/2006
- Last Update Date: 04/08/2022
Medicare PECOS Information:
- PECOS PAC ID: 0547234981
- Enrollment ID: I20110218000609
Medical Identifiers
Medical identifiers for Laureen Ann Gallo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1740251305 | NPI | - | NPPES |
| 146021800 | Medicaid | MD | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207R00000X | Internal Medicine | 0001194155 (Virginia) | Secondary |
| 363L00000X | Nurse Practitioner | AC000295 (Maryland) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Laureen Ann Gallo allows following entities to bill medicare on her behalf.
| Entity Name | Tidalhealth Peninsula Regional Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1184832040 PECOS PAC ID: 3072509702 Enrollment ID: O20040420001571 |
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| Entity Name | Tidalhealth Primary Care Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1104453208 PECOS PAC ID: 7911320635 Enrollment ID: O20200714000016 |
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| Entity Name | Tidalhealth Specialty Care Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1619504735 PECOS PAC ID: 7113340845 Enrollment ID: O20200714000286 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Laureen Ann Gallo is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Laureen Ann Gallo, CRNP MSN 400 Eastern Shore Dr Ste 204, Salisbury, MD 21804-5513 Ph: (410) 912-6716 | Laureen Ann Gallo, CRNP MSN 400 Eastern Shore Dr Ste 204, Salisbury, MD 21804-5513 Ph: (410) 912-6716 |
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