Individual provider Active NPI

Pia Maalouf, MD

  • Developmental - Behavioral Pediatrics Physician
  • Manchester, NH
National Provider Identifier
1093292070
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
24954 Issued in NH
Practice address
275 Mammoth Rd Ste 1
Manchester, NH 03109-4133
Phone
(603) 663-3222
NPI assigned
Jul 23, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 57.245636 OH
Student in an Organized Health Care Education/Training Program 390200000X LP05185 RI
Developmental - Behavioral Pediatrics Physician 2080P0006X 24954 NH Primary

Addresses

Primary practice location

275 Mammoth Rd Ste 1
Manchester, NH 03109-4133

Mailing address

275 Mammoth Rd Ste 1
Manchester, NH 03109-4133

Other practice location 1

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-5440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20240718000230 NH Practitioner - Pediatric Medicine 5193077493 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24954NHMDDevelopmental - Behavioral Pediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Elliot Professional Services CurrentSince Aug 1, 2024 Accepting new patients
Affinity Physicians LLC. Pediatrics Current Accepting new patients

Locations

275 Mammoth Rd
Ste 1
Manchester, NH 03109
Phone (603) 663-3222

1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2271

593 Eddy St
Providence, RI 02903

Interoperability endpoints

  • Direct secure messaging: pmaalouf@direct.carene.org

Organizations & group practices 2

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": "1532304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1093292070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 MAMMOTH RD STE 1",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031094133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 MAMMOTH RD STE 1",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031094133",
            "telephone_number": "603-663-3222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "593 Eddy St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034923",
            "country_code": "US",
            "telephone_number": "401-444-5440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAALOUF",
        "first_name": "PIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-23",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "57.245636",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "RI",
            "license": "LP05185",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "NH",
            "license": "24954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.