Amy J Malone, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA01024 Issued in TX

Practice address

1300 N 4TH St
Longview, TX 75601-4717

Phone

(903) 757-6042

Fax

(903) 758-1801

NPI assigned

Jul 28, 2005

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

Other identifiers 3

Other names 1

• Amy J Stacey Other name

Medicare fee-for-service enrollment

Enrolled in TX

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

University of Texas Southwestern Medical School at Dallas, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Oncology PAGroup PAC ID 5395658934, 1,001 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus Good Shepherd Medical Center Hospital, Longview, TX, CCN 450032
• Longview Regional Medical Center Hospital, Longview, TX, CCN 450702

Merit-based Incentive Payment System (MIPS)

Final score

85.12 of 100Reported as apm

Quality

67.48

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amy.stacey@txo.ikm.direct-ci.com

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.

• Texas Oncology PA

  • Medical Oncology Physician
  • El Paso, TX
  • NPI 1811944101
  Medicare reassignment Care Compare group NPD (past)
• Regional Clinics of Longview

  • Internal Medicine Physician
  • Longview, TX
  • NPI 1407047863
  Medicare reassignment NPD
• Texas Oncology PA

  • Medical Oncology Physician
  • Austin, TX
  • NPI 1972770303
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Christus Good Shepherd Medical Center

  • General Acute Care Hospital
  • Longview, TX
  • NPI 1124092036
  Care Compare affiliation
• Longview Medical Center LP

  • General Acute Care Hospital
  • Longview, TX
  • NPI 1528026267
  Care Compare affiliation

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1063412468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 911230",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753901230",
            "telephone_number": "972-997-8000",
            "fax_number": "972-234-0813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N 4TH ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756014717",
            "telephone_number": "903-757-6042",
            "fax_number": "903-758-1801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONE",
        "first_name": "AMY",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA0124",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA01024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204712803",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "361638502",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204712805",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "STACEY",
            "middle_name": "J",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Madysen House Enterprises
• Leigh Ann Mahjoobi, FNP
• Makona SNF, LLC
• Edward Tamayo Maldonado, C.R.N.A.
• Tariq S Malik, PA
• Diana Malone, MD
• David W Maly, CRNA
• Soumya Mamidi
• Edgar Ryan Mancilla
• Geeta Gyaneshwari Mandavilli

• Surgical Physician Assistant in Longview, TX
• Providers in Longview, TX by specialty
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; 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.