Destiney Malpass, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

9295 Medical Plaza Dr Ste a-B
North Charleston, SC 29406-9137

Phone

(843) 797-3960

NPI assigned

Feb 12, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trident Dermatology PAGroup PAC ID 5092774034, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Trident Dermatology, PA

  • Dermatology Physician
  • Charleston, SC
  • NPI 1366404659
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1613088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1023601853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 SMITH ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294011328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9295 MEDICAL PLAZA DR STE A-B",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069137",
            "telephone_number": "843-797-3960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALPASS",
        "first_name": "DESTINEY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-12",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renuka Mahatara, DO
• Margaret Mahoney, OTD R/L
• Julie T Malka, AUDIOLOGIST
• Jeema Maloney
• Caroline Malpass, STUDENT
• Regina Manfredi
• Mavis Manigault
• Victoria Manigault, CPNP
• Brandi L. Mann, DPT
• David C Mann, MD

• Physician Assistant in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.