STACIAN GALLIMORE-KING NP
NPI 1164090767
Nurse Practitioner - Family in Bronx, NY

Active since June 11, 2021PECOS Enrolled
100/100
CMS Quality Rating
1695 EASTCHESTER RD, BRONX, NY 10461(718) 405-8505 Get Directions Write a Review

NPPES record last updated: October 18, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 18, 2021, Jun 11, 2021 (2 updates tracked since 2021).

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

NPI1164090767
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSTACIAN GALLIMORE-KINGCredential: NP
Location Address1695 EASTCHESTER RDBronx, NY 10461-2374
Mailing Address3044 Ely AveBronx, NY 10469-3227 · (718) 924-1601
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateJune 11, 2021
Last NPPES UpdateOctober 18, 20212 updates tracked since enumeration
NPPES CertifiedOctober 18, 2021
NPI 1164090767 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in NY · 0516845
1695 EASTCHESTER RD, Bronx, NY 10461

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Stacian Gallimore-king Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4486046364
PECOS Enrollment IDI20220127000011
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.

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, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330059
Location111 East 210th StreetBronx, NY 10467 · Bronx County
Emergency services Birthing friendly

Physician 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.

New Patient
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability100
Improvement Activities40

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.

Social Worker (Clinical)
1695 EASTCHESTER RD
BRONX, NY 10461
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
1695 EASTCHESTER RD
BRONX, NY 10461
Pharmacist
1695 EASTCHESTER RD, ROOM C-136
BRONX, NY 10461
Internal Medicine (Hematology & Oncology)
1695 EASTCHESTER RD
BRONX, NY 10461
Urology
1695 EASTCHESTER RD, SUITE 306
BRONX, NY 10461
Obstetrics & Gynecology
1695 EASTCHESTER RD, SUITE L2
BRONX, NY 10461
Urology
1695 EASTCHESTER RD, SUITE 501
BRONX, NY 10461
Obstetrics & Gynecology (Gynecologic Oncology)
1695 EASTCHESTER RD, SUITE 601
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.

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 4 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.