Individual provider Active NPI

Marshall P. Mallory, M.D.

  • Diagnostic Radiology Physician
  • Gadsden, AL
National Provider Identifier
1083620447
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
12378 Issued in AL
Practice address
20 Indian Pine Trce W
Gadsden, AL 35901-7240
Phone
(888) 318-8900
Fax
(408) 370-9131
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 244168 NY
Diagnostic Radiology Physician 2085R0202X 12378 AL Primary

Addresses

Primary practice location

20 Indian Pine Trce W
Gadsden, AL 35901-7240

Mailing address

PO Box 320757
Los Gatos, CA 95032-0112
Phone (888) 318-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, NY, MD, DC, FL5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20050211000851 AL Practitioner - Diagnostic Radiology 4789636267 Reassigns benefits to 1 organization
I20220301000588 NY Practitioner - Diagnostic Radiology 4789636267 Reassigns benefits to 2 organizations
I20221219001503 MD Practitioner - Diagnostic Radiology 4789636267 Reassigns benefits to 1 organization
I20230807001628 DC Practitioner - Diagnostic Radiology 4789636267 Reassigns benefits to 3 organizations
I20251009001517 FL Practitioner - Diagnostic Radiology 4789636267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical College of Georgia School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Services of Holy CrossGroup PAC ID 3779516992, 159 clinicians
Lifebridge Community Physicians IncGroup PAC ID 3678751468, 183 clinicians
Jamaica HospitalGroup PAC ID 2264324334, 252 clinicians
Blackwell Physicians, LLCGroup PAC ID 2163810383, 67 clinicians

Practice addresses (Care Compare)

19801 Observation Dr
Germantown, MD 20876-4070
Phone (301) 557-6000

2401 W Belvedere Ave
LBH Medical Group Teleradiology
Baltimore, MD 21215-5216
Phone (410) 601-9000

8900 Van Wyck Expy
Jamaica, NY 11418-2832
Phone (718) 206-6000

9901 Medical Ctr Dr
Rockville, MD 20850-3357
Phone (240) 826-6074

Hospital & facility affiliations

  • Adventist Healthcare White Oak Medical Center Hospital, Silver Spring, MD, CCN 210016
  • Adventist Healthcare Shady Grove Medical Center Hospital, Rockville, MD, CCN 210057
  • Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165
  • Holy Cross Hospital Hospital, Silver Spring, MD, CCN 210004
  • Flushing Hospital Medical Center Hospital, Flushing, NY, CCN 330193

Merit-based Incentive Payment System (MIPS)

Final score
92.19 of 100Reported as group
Quality
82.16
Promoting interoperability
79
Improvement activities
40
Cost
75.98

Merit-based Incentive Payment System (MIPS)

Final score
83.23 of 100Reported as group
Quality
60.26
Promoting interoperability
100
Improvement activities
40
Cost
76.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12378ALMDDiagnostic Radiology Physician
244168NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Professional Corporation CurrentSince Feb 12, 2024 Accepting new patients
Jamaica Hospital CurrentSince Apr 1, 2022 Accepting new patients
Lifebridge Community Physicians, Inc Current Accepting new patients
Professional Services of Holy Cross CurrentSince Jun 24, 2023 Accepting new patients
Professional Services of Holy Cross CurrentSince Jun 24, 2023 Accepting new patients
Lifebridge Community Physicians, Inc CurrentSince Dec 12, 2022 Accepting new patients
Adventist Physician Services, Inc. CurrentSince Jul 2, 2025 Accepting new patients
Lifebridge Community Physicians Inc CurrentSince Dec 12, 2022 Accepting new patients
TJH Medical Services, P.C. CurrentSince Feb 3, 2024 Accepting new patients
Eastpointe Radiologists, P.C. Diagnostic Radiology CurrentSince Feb 2, 2024 Accepting new patients
Blackwell Physicians, LLC Diagnostic Radiology CurrentSince Jul 2, 2025 Accepting new patients
Jamaica Hospital CurrentSince Apr 1, 2022 Accepting new patients
Mori Bean and Brooks Inc Diagnostic Radiology CurrentSince Oct 1, 2025 Accepting new patients
Eastpointe Radiologists, PC Diagnostic Radiology Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations (25 of 29)

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

13695 US Highway 1
Sebastian, FL 32958
Phone (772) 589-3185

2115 Little Rd
Trinity, FL 34655
Phone 7278418225410

2401 W Belvedere Ave
Baltimore, MD 21215

820 W Diamond Ave
Ste 500
Gaithersburg, MD 20878

19801 Observation Dr
Germantown, MD 20876
Phone (301) 557-5928

9601 Blackwell Rd
Ste 150
Rockville, MD 20850
Phone (240) 864-1100

9901 Medical Center Dr
Rockville, MD 20850
Phone (301) 279-6000

1500 Forest Glen Rd
Silver Spring, MD 20910
Phone (301) 754-7230

410 Malcolm Dr
Ste A
Westminster, MD 21157
Phone (410) 876-1633

36750 26 Mile Rd
Chesterfield, MI 48047
Phone (586) 879-2000

51307 Gratiot Ave
Chesterfield, MI 48051
Phone (586) 741-3772

43900 Garfield Rd
Ste 222
Clinton Twp, MI 48038
Phone (586) 263-1234

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

17141 Kercheval Ave
Grosse Pointe, MI 48230
Phone (313) 642-4980

17700 23 Mile Rd
Macomb, MI 48044
Phone (586) 416-7500

46591 Romeo Plank Rd
Macomb, MI 48044
Phone (586) 226-6269

46591 Romeo Plank Rd
Ste 220
Macomb, MI 48044
Phone (586) 226-6170

13350 24 Mile Rd
Ste 200
Shelby Township, MI 48315
Phone (586) 566-7100

21000 E 12 Mile Rd
St Clr Shores, MI 48081
Phone (586) 447-5000

64580 Van Dyke Rd
Ste C
Washington Township, MI 48095
Phone (586) 752-9483

4500 Parsons Blvd
Flushing, NY 11355
Phone (718) 670-5631

11940 Metropolitan Ave
Kew Gardens, NY 11415
Phone (718) 849-0839

80 Marcus Dr
Melville, NY 11747
Phone (631) 391-7889

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

Interoperability endpoints

  • Direct secure messaging: mmallory1139968@direct.hfhs.org

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1083620447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 320757",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950320112",
            "telephone_number": "888-318-8900",
            "fax_number": "408-370-9131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 INDIAN PINE TRCE W",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359017240",
            "telephone_number": "888-318-8900",
            "fax_number": "408-370-9131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLORY",
        "first_name": "MARSHALL",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "244168",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AL",
            "license": "12378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gadsden, AL

Sources for this page

Verify at the official NPI Registry.