Individual provider Active NPI

Marilyn Malia

  • Family Medicine Physician
  • St Petersburg, FL
National Provider Identifier
1083146898
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
83350 Issued in SC
Practice address
6500 38TH Ave N
Saint Petersburg, FL 33710-1629
Phone
(727) 384-7727
NPI assigned
Mar 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 83350 SC Primary

Addresses

Primary practice location

6500 38TH Ave N
Saint Petersburg, FL 33710-1629

Mailing address

6500 38TH Ave N
Saint Petersburg, FL 33710-1629

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201022002847 SC Practitioner - Family PracticePractitioner - Hospitalist 8527488931 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Edward Via Col of Osteo Medicine-Carolinas Campus, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SC House Calls IncGroup PAC ID 6800994807, 445 clinicians

Practice addresses (Care Compare)

1053 Ctr St
West Columbia, SC 29169-6749
Phone (800) 491-0909

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
83350SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Family Care, Inc Family Medicine CurrentSince Jan 14, 2021 Accepting new patients
SC House Calls Inc Family Medicine CurrentSince Sep 29, 2021 Accepting new patients
Carolina Family Care, Inc Family Medicine CurrentSince Jan 14, 2021 Accepting new patients
SC House Calls Inc CurrentSince Sep 29, 2021 Accepting new patients

Locations

805 Pamplico Hwy
Florence, SC 29505
Phone (843) 674-2500

1341 Old Georgetown Rd
Ste C
Mt Pleasant, SC 29464
Phone (843) 884-2175

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

1053 Center St
West Columbia, SC 29169
Phone (803) 454-0365

Interoperability endpoints

  • Direct secure messaging: marilyn.malia@hca4.eclinicaldirectplus.com
  • Direct secure messaging: marilyn.malia.1@7602.direct.athenahealth.com

Organizations & group practices 5

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": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1083146898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 38TH AVE N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337101629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 38TH AVE N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337101629",
            "telephone_number": "727-384-7727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALIA",
        "first_name": "MARILYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-30",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "83350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.