NICHOLAS GAMMELLO
NPI 1558383000
Psychologist in Brainerd, MN

Active since July 24, 2006
18510 STATE HIGHWAY 371 STE D, BRAINERD, MN 56401(218) 838-4209 Get Directions Write a Review

NPPES record last updated: November 19, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 19, 2024, Nov 9, 2024, Mar 10, 2022 and 1 more (4 updates tracked since 2019).

About Nicholas Gammello NPPES

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

NICHOLAS GAMMELLO (NPI 1558383000) is an individual psychologist in Brainerd, Minnesota, licensed in Minnesota (1437) and active in the NPI registry since July 2006.

NPPES Registry Identity

NPI1558383000
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameNICHOLAS GAMMELLO
Location Address18510 STATE HIGHWAY 371 STE DBrainerd, MN 56401-6996
Mailing Address11636 Fairway RdEast Gull Lake, MN 56401-2099 · (218) 838-4209
Sole ProprietorNo
Enumeration DateJuly 24, 2006
Last NPPES UpdateNovember 19, 20244 updates tracked since enumeration
NPPES CertifiedNovember 19, 2024
✔ NPI 1558383000 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in MN · 1437
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
18510 STATE HIGHWAY 371 STE D, Brainerd, MN 56401

Other Identifiers 2

Other62Q99GAMN · Blue Cross
Medicaid731353500MN

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicholas Gammello is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Nicholas Gammello reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Community/Behavioral Health
2310 NW 3RD ST
Grand Rapids, MN 55744
  • Reassigned Medicare billing, Minnesota enrollment
  • 35 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.

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 Nicholas Gammello's NPI number?

The NPI number for Nicholas Gammello is 1558383000. It was assigned to this individual provider in the NPPES registry on July 24, 2006.

Where is Nicholas Gammello located?

Nicholas Gammello practices at 18510 State Highway 371 Ste D, Brainerd, MN 56401. The listed phone number is (218) 838-4209.

What is Nicholas Gammello's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Nicholas Gammello enrolled in Medicare?

Yes. Nicholas Gammello is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Nicholas Gammello's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicholas Gammello reassigns Medicare benefits to Lakeview Behavioral Health Inc. (Grand Rapids, MN). 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 Nicholas Gammello's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Nicholas Gammello was last updated on November 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.