DR. LISA ANN GALLAGHER DO
NPI 1235499153
Family Medicine in Elverson, PA

Q: What is Lisa Gallagher's NPI number?

The NPI number for Lisa Gallagher is 1235499153. It was assigned to this individual provider in the NPPES registry on May 24, 2012.

Q: What is Lisa Gallagher's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Lisa Gallagher was last updated on April 23, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.

Active since May 24, 2012PECOS EnrolledAccepts Medicare Assignment

81.19/100

CMS Quality Rating

315 DARBY SQ, ELVERSON, PA 19520(610) 898-5240(610) 286-6760 Get Directions Write a Review

NPPES record last updated: April 23, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 23, 2018, Jun 15, 2017 (2 updates tracked since 2017).

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About Dr. Lisa Ann Gallagher Do NPPES

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

DR. LISA ANN GALLAGHER DO (NPI 1235499153) is an individual family medicine provider in Elverson, Pennsylvania, licensed in Pennsylvania (OS018456) and active in the NPI registry since May 2012. She is enrolled in Medicare PECOS, is affiliated with Reading Hospital, and is a graduate of Philadelphia College Of Osteopathic Medicine (2011).

NPPES Registry Identity

NPI1235499153

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDR. LISA ANN GALLAGHERCredential: DO

Location Address315 DARBY SQElverson, PA 19520-9302

Mailing AddressP.o. Box 13579Reading, PA 19612-3579

Phone(610) 898-5240

Fax(610) 286-6760

Sole ProprietorNo

Medical School CMSPhiladelphia College Of Osteopathic MedicineGraduated 2011

Enumeration DateMay 24, 2012

Last NPPES UpdateApril 23, 20182 updates tracked since enumeration

✔ NPI 1235499153 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in PA · OS018456✔ Licensed in FL · OS11967

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

315 DARBY SQ, Elverson, PA 19520

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Other Identifiers 2

Medicaid103290355PA

Other14U7PFL · Bcbs

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Lisa Ann Gallagher Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4385872274

PECOS Enrollment IDI20170608000719

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.

Areas of Expertise CMS Part B claims 14

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

409 services231 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

163 services163 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

95 services74 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

59 services12 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

41 services41 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

22 services21 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

19 services18 patients

Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) G0506

This service involves a thorough evaluation of patients needing ongoing care for chronic conditions. It includes creating a tailored care plan, coordinating with healthcare providers, and monitoring progress regularly. The goal is to provide optimal, personalized care for your long-term health needs.

18 services18 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

17 services17 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

15 services13 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

13 services13 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

13 services13 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

13 services13 patients

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402

An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.

11 services11 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Reading Hospital

Acute Care Hospitals · West Reading, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390044

Location420 S 5th AvenueWest Reading, PA 19611 · Berks County

Emergency services Birthing friendly

Pottstown Hospital

Acute Care Hospitals · Pottstown, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390123

Location1600 East High StreetPottstown, PA 19464 · Montgomery County

Emergency services

Phoenixville Hospital

Acute Care Hospitals · Phoenixville, PA

3/5 CMS rating

OwnershipProprietary

CMS Certification Number390127

Location140 Nutt RoadPhoenixville, PA 19460 · Chester County

Emergency services Birthing friendly

Paoli Hospital

Acute Care Hospitals · Paoli, PA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390153

Location255 West Lancaster AvenuePaoli, PA 19301 · Chester County

Emergency services Birthing friendly

Chester County Hospital

Acute Care Hospitals · West Chester, PA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390179

Location701 East Marshall StreetWest Chester, PA 19380 · Chester County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19520 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

$92.69 typical visit price

range $59.88 – $180.99

Typical copayment $23.17 (range $14.97 – $45.24)

Most-billed visit code 99203

Established Patient

$105.21 typical visit price

range $19.30 – $147.29

Typical copayment $26.30 (range $4.82 – $36.82)

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.

81.19/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

74.56

Promoting Interoperability

Improvement Activities

Cost

65.23

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

12%177 patients1/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

5 suppliers13 claims46 services$6.96 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

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

SIERRA D HYATT CRNP

Nurse Practitioner (Family)

315 DARBY SQ
ELVERSON, PA 19520

Chester County (610) 898-5240

DR. JEFFREY W MUMIE D.O.

Family Medicine

315 DARBY SQ
ELVERSON, PA 19520

Chester County (610) 898-5240

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 Lisa Gallagher's NPI number?

The NPI number for Lisa Gallagher is 1235499153. It was assigned to this individual provider in the NPPES registry on May 24, 2012.

Where is Lisa Gallagher located?

Lisa Gallagher practices at 315 Darby Sq, Elverson, PA 19520. The listed phone number is (610) 898-5240.

What is Lisa Gallagher's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Lisa Gallagher enrolled in Medicare?

Yes. Lisa Gallagher is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Lisa Gallagher accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Lisa Gallagher as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Lisa Gallagher affiliated with any hospitals?

According to CMS data, Lisa Gallagher is affiliated with Reading Hospital, Pottstown Hospital, Phoenixville Hospital, Paoli Hospital and Chester County Hospital.

When was this NPI record last updated?

The NPPES record for Lisa Gallagher was last updated on April 23, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.