DR. GARY ANTHONY GALLO M.D. NPI 1003021825

Orthopaedic Surgery in Naples, FL

Individual Male Years of Experience 60 Orthopaedic Surgery PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 95 Medicare Quality Reporting

About DR. GARY ANTHONY GALLO M.D.

Gary Gallo is a provider established in Naples, Florida and his medical specialization is Orthopaedic Surgery with more than 60 years of experience. He graduated from New York Medical College in 1963. The NPI number of Gary Gallo is 1003021825 and was assigned on May 2007. The practitioner's primary taxonomy code is 207X00000X with license number ME81511 (FL). The provider is registered as an individual and his NPI record was last updated 3 years ago.

NPI

1003021825

Provider NameDR. GARY ANTHONY GALLO M.D.
Provider Location Address8300 COLLIER BLVD NAPLES, FL 34114
Provider Mailing Address5220 BELFORT RD SUITE 130 JACKSONVILLE, FL 32256
GenderMale
NPI Entity TypeIndividual
Medical School NameNEW YORK MEDICAL COLLEGE
Graduation Year1963
Is Sole Proprietor?No
Enumeration Date05-14-2007
Last Update Date09-30-2019



Gary Gallo is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Gary Gallo is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with Physicians Regional Medical Center - Pine Ridge and Naples Community Hospital.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 95, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance. The provider also has detailed performance information the following quality measures: closing the referral loop: receipt of specialist report, documentation of current medications in the medical record, falls: screening for future fall risk, implementation of fall screening and assessment programs, implementation of formal quality improvement methods, practice changes, or other practice improvement processes, measurement and improvement at the practice and panel level, pneumococcal vaccination status for older adults, preventive care and screening: tobacco use: screening and cessation intervention, regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms. and use of high-risk medications in the elderly.

The typical physician office visit costs for Medicare beneficiaries in this area are: $23.66 for a new patient copayment and $19.1 for an established patient copayment.



Primary Taxonomy

Taxonomy Code207X00000X
ClassificationOrthopaedic Surgery
TypeAllopathic & Osteopathic Physicians
License No.ME81511
License StateFL
Taxonomy DescriptionAn orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Business Address

DR. GARY ANTHONY GALLO M.D.
8300 COLLIER BLVD
NAPLES, FL
ZIP 34114
Phone: (239) 354-6000

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Mailing Address

DR. GARY ANTHONY GALLO M.D.
5220 BELFORT RD
SUITE 130
JACKSONVILLE, FL
ZIP 32256
Phone: (904) 446-3451
Fax: (904) 446-3013


PECOS Enrollment and Medicare Participation

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
PECOS PAC ID3274757554
PECOS Enrollment IDI20140605001988
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Physician Office Visit Costs

The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 34114 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99203
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$61.36 $187 $94.64
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$15.34 $46.75 $23.66
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99213
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$18.68 $151.65 $76.4
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.67 $37.91 $19.1

* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in Medicare's Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

MIPS Measure Score Weight Score
Quality 40% 90.7
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
Promoting Interoperability (PI) 25% N/A
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.
Improvement Activities 15% 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs.

The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.
Cost 20% N/A
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
MIPS Final Score - 95
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

MIPS Quality Measures

The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.

Quality Measure Performance Number of Patients
Closing the Referral Loop: Receipt of Specialist Report 100% 28
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
Documentation of Current Medications in the Medical Record 93% 876
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
Falls: Screening for Future Fall Risk 95% 331
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
Implementation of fall screening and assessment programsYesN/A
Implementation of fall screening and assessment programs to identify patients at risk for falls and address modifiable risk factors (e.g., Clinical decision support/prompts in the electronic health record that help manage the use of medications, such as benzodiazepines, that increase fall risk).
Implementation of formal quality improvement methods, practice changes, or other practice improvement processesYesN/A
Adopt a formal model for quality improvement and create a culture in which all staff actively participates in improvement activities that could include one or more of the following such as: - Multi-Source Feedback; - Train all staff in quality improvement methods; - Integrate practice change/quality improvement into staff duties; - Engage all staff in identifying and testing practices changes; - Designate regular team meetings to review data and plan improvement cycles; - Promote transparency and accelerate improvement by sharing practice level and panel level quality of care, patient experience and utilization data with staff; and/or - Promote transparency and engage patients and families by sharing practice level quality of care, patient experience and utilization data with patients and families, including activities in which clinicians act upon patient experience data.
Measurement and Improvement at the Practice and Panel LevelYesN/A
Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following:- Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or - Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level.
Pneumococcal Vaccination Status for Older Adults 92% 331
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 4% 48
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms.YesN/A
Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms.
Use of High-Risk Medications in the Elderly 2% "Inverse Quality Measure"
This is an inverse quality measure, a lower rate means the provider is rated better.
323
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted.1) Percentage of patients who were ordered at least one high-risk medication2) Percentage of patients who were ordered at least two of the same high-risk medication

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 798Management and supervision of oxygen chamber therapy per session (HCPCS:99183)
  • 651Removal of skin and tissue first 20 sq cm or less (HCPCS:11042)
  • 378Removal of tissue from wounds per session (HCPCS:97597)

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Gary Gallo is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
PHYSICIANS REGIONAL MEDICAL CENTER - PINE RIDGE6101 PINE RIDGE ROAD
NAPLES, FL 34119
(239) 348-4000Acute Care Hospitals100286
NAPLES COMMUNITY HOSPITAL350 7TH ST N
NAPLES, FL 34102
(239) 436-5000Acute Care Hospitals100018

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
12083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric MedicineME81511FLNo

Taxonomy Description: a specialist who treats decompression illness and diving accident cases and uses hyperbaric oxygen therapy to treat such conditions as carbon monoxide poisoning, gas gangrene, non-healing wounds, tissue damage from radiation and burns and bone infections. This specialist also serves as consultant to other physicians in all aspects of hyperbaric chamber operations and assesses risks and applies appropriate standards to prevent disease and disability in divers and other persons working in altered atmospheric conditions.

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1003021825
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
200302284
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 2 + 2 + 8 + 4 + 24 = 45
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 45 = 55

The NPI number 1003021825 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1487651592 TODD E CARLSON M.D.
Individual
Emergency Medicine8300 COLLIER BLVD
NAPLES, FL 34114
(239) 354-6190
1144241696 MIN CHUNG KIM MD
Individual
Emergency Medicine8300 COLLIER BLVD
NAPLES, FL 34114
(239) 354-6000
1669520409COLLIER EMERGENCY SPECIALISTS LLC
Organization
Emergency Medicine8300 COLLIER BLVD PHYSICIAN'S REGIONAL MEDICAL CENTER - COLLIER BLVD
NAPLES, FL 34114
(239) 354-6000
1194989699COLLIER UNITED RADIOLOGY INC
Organization
Radiology (Diagnostic Radiology)8300 COLLIER BLVD
NAPLES, FL 34114
(239) 354-6000
1780900217NAPLES PRMC EMERGENCY PHYSICIANS LLC
Organization
Hospitalist8300 COLLIER BLVD
NAPLES, FL 34114
(877) 693-5700
1972823060COMPREHENSIVE HOSPITALIST SERVICES OF NAPLES LLC
Organization
Hospitalist8300 COLLIER BLVD
NAPLES, FL 34114
(877) 693-5700
1841590965PHYSICIANS REGIONAL MEDICAL CENTER - COLLIER BLVD
Organization
Clinic/Center (Radiology)8300 COLLIER BLVD
NAPLES, FL 34114
(813) 899-6226
1093011769NAPLES HMA, LLC
Organization
Internal Medicine (Critical Care Medicine)8300 COLLIER BLVD
NAPLES, FL 34114
(772) 581-6226
1841583515COLLIER EMERGENCY GROUP LLC
Organization
Emergency Medicine8300 COLLIER BLVD
NAPLES, FL 34114
(239) 354-6000
1396033452COLLIER PHYSICIAN SERVICES LLC
Organization
Hospitalist8300 COLLIER BLVD
NAPLES, FL 34114
(239) 354-6000
1700166899NAPLES HMA INC, DBA PHYSICIANS REGIONAL MEDICAL CENTER
Organization
General Acute Care Hospital8300 COLLIER BLVD
NAPLES, FL 34114
(239) 354-6000
1750624573 JAY JAMES MARTINEZ
Individual
Pharmacist8300 COLLIER BLVD
NAPLES, FL 34114
(239) 354-6063
1932442753 MARY A KOSSOWSKI PHARM.D.
Individual
Pharmacist8300 COLLIER BLVD
NAPLES, FL 34114
(239) 354-6063
1184038531SANDPIPER INPATIENT SERVICES LLC
Organization
Internal Medicine8300 COLLIER BLVD
NAPLES, FL 34114
(239) 354-6000
1811302268FLORIDA EM-I MEDICAL SERVICES PA
Organization
Emergency Medicine8300 COLLIER BLVD
NAPLES, FL 34114
(239) 354-6000
1982019329QUAIL EMERGENCY PHYSICIANS LLC
Organization
Emergency Medicine8300 COLLIER BLVD
NAPLES, FL 34114
(239) 354-6000
1649668989 KOURTNEY MARSH PHARMD
Individual
Pharmacist8300 COLLIER BLVD
NAPLES, FL 34114
(239) 354-6062
1376924134 JENNIFER ANN GERARD B.PHARM
Individual
General Acute Care Hospital8300 COLLIER BLVD
NAPLES, FL 34114
(239) 292-2267
1003265737DR. MATTHEW SANGER PHARMD
Individual
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)8300 COLLIER BLVD
NAPLES, FL 34114
(239) 354-6063
1144778879 STEWART SHRADER PHARM.D.
Individual
Pharmacist8300 COLLIER BLVD
NAPLES, FL 34114
(239) 354-6000

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Dr. Gary Anthony Gallo M.d. is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.