Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Allie Pangallo

Individual provider Physician Assistant · NPI 1407609688

Allie Pangallo is a Physician Assistant in Edgewood, Kentucky. Qualified in 2024, 2 years ago. Practices with Radiology Associates of Northern Kentucky PLLC, a 56-clinician group, works from 2 locations and accepts Medicare assignment.

Years since qualifying
2
In the registry since
2024
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Practice location Address checks out

1 Medical Village Dr
Edgewood, KY 41017-3403
Phone: (610) 477-6147
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 375 Thomas More Pkwy Ste 209, Crestview Hills, KY 41017-2175 — (859) 331-4369

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1407609688
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 8, 2024
Last updated in NPPESMarch 19, 2025
Certification dateMarch 19, 2025
Mailing address8538 Strimple Rd, Cleves, OH 45002-9780

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Radiology Associates Of Northern Kentucky Pllc — 56 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations11 on file with Medicare

Other providers in Edgewood