Mallory Anne Smallze

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

26NJ01325700 Issued in NJ

Practice address

22-18 Broadway
Fair Lawn, NJ 07410-3016

Phone

(201) 414-9840

NPI assigned

Jul 13, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: msmallze1017005@direct.ahn.org

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.

• Medical Associates of Englewood, PC

  • Internal Medicine Physician
  • Englewood, NJ
  • NPI 1952681918
  Medicare reassignment NPD

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

{
    "created_epoch": "1657670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1053045203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 DOROTHY AVE",
            "city": "ROCHELLE PARK",
            "state": "NJ",
            "postal_code": "076623303",
            "telephone_number": "201-421-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22-18 BROADWAY",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074103016",
            "telephone_number": "201-414-9840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALLZE",
        "first_name": "MALLORY",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-13",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ01325700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Irena Skibinsky, D.M.D
• Ashley Skrec, M.A. CCC-SLP
• Miriam Skydell
• Slade Enterprise Inc
• Michael S Slade, M.D.
• Smile Loft Fair Lawn, LLC
• Smilify of Fair Lawn
• Dawn Marie Smith, LPC
• Terence Jay Smith, DDS
• Joseph Smotkin, MD

• Nurse Practitioner in Fair Lawn, NJ
• Providers in Fair Lawn, NJ by specialty
• Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.