Individual provider Active NPI

Michelle Kay Malchow, O.D.

  • Optometrist
  • Crosby, MN
National Provider Identifier
1023343100
Registry record updated Aug 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3447 Issued in MN
Practice address
One 3Rd Avenue NE
Crosby, MN 56441-1667
Phone
(218) 546-5108
Fax
(218) 546-5736
NPI assigned
Oct 7, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3447 MN Primary

Addresses

Primary practice location

One 3Rd Avenue NE
Crosby, MN 56441-1667

Mailing address

One 3Rd Avenue NE
Crosby, MN 56441-1667
Phone (218) 546-5108

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150728003064 MN Practitioner - Optometry 7012185887 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associates in EyecareGroup PAC ID 4082017587, 3 clinicians

Practice addresses (Care Compare)

14453 Edgewood Dr
Baxter, MN 56425-8459
Phone (218) 829-1789

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
S Sjoberg PLC Optometrist CurrentSince Aug 3, 2015 Accepting new patients
Associates in Eyecare Optometrist CurrentSince Jan 31, 2022 Accepting new patients
S Sjoberg PLC Optometrist CurrentSince Aug 3, 2015 Accepting new patients

Locations

7636 Design Rd
Ste 105
Baxter, MN 56425
Phone (218) 546-5708

14453 Edgewood Dr
Baxter, MN 56425
Phone (218) 829-1789

1 3rd Ave NE
Crosby, MN 56441
Phone (218) 546-5108

5457 City Hall St
Nisswa, MN 56468
Phone (218) 963-2020

424 Barclay Ave
Pine River, MN 56474
Phone (218) 587-2020

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1254873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440720000000",
    "number": "1023343100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE 3RD AVENUE NE",
            "city": "CROSBY",
            "state": "MN",
            "postal_code": "564411667",
            "telephone_number": "218-546-5108",
            "fax_number": "218-546-5736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE 3RD AVENUE NE",
            "city": "CROSBY",
            "state": "MN",
            "postal_code": "564411667",
            "telephone_number": "218-546-5108",
            "fax_number": "218-546-5736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALCHOW",
        "first_name": "MICHELLE",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-07",
        "last_updated": "2015-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crosby, MN

Sources for this page

Verify at the official NPI Registry.