SAMANTHA JO GALLO P.A.
NPI 1114574084
Physician Assistant - Medical in Fresno, CA

Q: What is Samantha Gallo's NPI number?

The NPI number for Samantha Gallo is 1114574084. It was assigned to this individual provider in the NPPES registry on August 24, 2019.

Q: What is Samantha Gallo's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Samantha Gallo was last updated on August 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 24, 2019PECOS Enrolled

1245 E HERNDON AVE, FRESNO, CA 93720(559) 664-4000(559) 675-5224 Get Directions Write a Review

NPPES record last updated: August 15, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 15, 2025, Nov 30, 2021, Aug 24, 2019 (3 updates tracked since 2019).

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About Samantha Jo Gallo P.a. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMANTHA JO GALLO P.A. (NPI 1114574084) is an individual medical provider in Fresno, California, licensed in California (PA60382) and active in the NPI registry since August 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114574084

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameSAMANTHA JO GALLOCredential: P.A.

Location Address1245 E HERNDON AVEFresno, CA 93720-3235

Mailing Address1245 E Herndon AveFresno, CA 93720-3235 · (559) 664-4000 · Fax (559) 675-5224

Phone(559) 664-4000

Fax(559) 675-5224

Sole ProprietorYes

Enumeration DateAugust 24, 2019

Last NPPES UpdateAugust 15, 20253 updates tracked since enumeration

NPPES CertifiedAugust 15, 2025

✔ NPI 1114574084 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in CA · PA60382

1245 E HERNDON AVE, Fresno, CA 93720

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samantha Jo Gallo P.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

COH SERVICES INCORPORATED

Preventive Medicine (Occupational Medicine)