STACIAN GALLIMORE-KING NP
NPI 1164090767
Nurse Practitioner - Family in Bronx, NY
About Stacian Gallimore-king Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
STACIAN GALLIMORE-KING NP (NPI 1164090767) is an individual family provider in Bronx, New York, licensed in New York (0516845) and active in the NPI registry since June 2021. She is enrolled in Medicare PECOS, is affiliated with Montefiore Medical Center, and is a graduate of Other (2019).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Stacian Gallimore-king Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Stacian Gallimore-king reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Bronx, NY 10467
- Reassigned Medicare billing, New York enrollment
- 5,251 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Montefiore Medical Center
Acute Care Hospitals · Bronx, NYPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 10461 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BRONX, NY 10461
BRONX, NY 10461
BRONX, NY 10461
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Stacian Gallimore-king's NPI number?
The NPI number for Stacian Gallimore-king is 1164090767. It was assigned to this individual provider in the NPPES registry on June 11, 2021.
Where is Stacian Gallimore-king located?
Stacian Gallimore-king practices at 1695 Eastchester Rd, Bronx, NY 10461. The listed phone number is (718) 405-8505.
What is Stacian Gallimore-king's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Stacian Gallimore-king enrolled in Medicare?
Yes. Stacian Gallimore-king is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Stacian Gallimore-king's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Stacian Gallimore-king reassigns Medicare benefits to Montefiore Medical Center (Bronx, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Stacian Gallimore-king's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Stacian Gallimore-king affiliated with any hospitals?
According to CMS data, Stacian Gallimore-king is affiliated with Montefiore Medical Center.
When was this NPI record last updated?
The NPPES record for Stacian Gallimore-king was last updated on October 18, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.
# Stacian Gallimore-King, NP · NPI 1164090767
Family physician in Bronx, New York. Individual provider, active in the CMS NPPES registry since June 11, 2021.
## Identity
- **NPI:** 1164090767 (Entity type: Individual)
- **Enumerated:** June 11, 2021
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 0516845 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 1695 EASTCHESTER RD, Bronx, NY 10461-2374
- **Phone:** (718) 405-8505
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Montefiore Medical Center (NPI 1063525152, Bronx, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** October 18, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1164090767) · Data from the CMS NPPES public registry.