Jessie E. Mallalieu, P.A.-C.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C02972 Issued in MD

Practice address

63 Thomas Johnson Dr
Suite B
Frederick, MD 21702-4384

Phone

(301) 698-2424

NPI assigned

Jan 26, 2007

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 MD

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, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michael R. Warner MdpaGroup PAC ID 5496648065, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Michael R. Warner Mdpa

  • MOHS-Micrographic Surgery Physician
  • Frederick, MD
  • NPI 1578742250
  Medicare reassignment Care Compare group
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363910400000",
    "number": "1073669784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 THOMAS JOHNSON DR",
            "address_2": "SUITE B",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024384",
            "telephone_number": "301-698-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 THOMAS JOHNSON DR",
            "address_2": "SUITE B",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024384",
            "telephone_number": "301-698-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLALIEU",
        "first_name": "JESSIE",
        "middle_name": "E.",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2013-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C02972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Malcolm, MD
• Diego Emilio Maldonado, DDS
• Anwar K. Malik, M.B.,B.S.
• Jawad Malik, M.D.
• Muneeb S Malik, MD
• Hillary F. Mallette, LCSW-C
• Jade Anabella Manche
• Salvatore Mancino, DPT
• Rachel I Mandel, MD
• Madilyn Mandich, DPT

• Physician Assistant in Frederick, MD
• Providers in Frederick, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2013; 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.