Individual provider Active NPI

Paris L Malin, DPM

  • Podiatrist
  • Sylvania, OH
National Provider Identifier
1104266030
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
36.003758 Issued in OH
Practice address
5300 Harroun Rd Ste 201
Sylvania, OH 43560-2146
Phone
(419) 885-5563
Fax
(419) 885-5439
NPI assigned
Jun 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 36.003758 OH Primary

Addresses

Primary practice location

5300 Harroun Rd Ste 201
Sylvania, OH 43560-2146

Mailing address

333 N Summit St FL 7
Toledo, OH 43604-1531

Other identifiers 1

IdentifierTypeStateIssuer
36.003758OtherOHOHIO MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230907000693 WA Practitioner - Podiatry 5597060400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PNC Podiatry of Washington PLLCGroup PAC ID 3971950312, 13 clinicians

Practice addresses (Care Compare)

1823 37TH St
Suite a
Everett, WA 98201-5089
Phone (425) 822-7426

Hospital & facility affiliations

  • Providence Regional Medical Center Everett Hospital, Everett, WA, CCN 500014

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue13
Removal of skin lesions1-10
Removal of nail tissue105
Removal or shaving of skin growth49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36.003758OHMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
PNC Podiatry of Washington PLLC Podiatrist CurrentSince Nov 1, 2023 Accepting new patients
PNC Podiatry of Washington PLLC CurrentSince Nov 1, 2023 Accepting new patients

Locations

1823 37th St
Ste A
Everett, WA 98201
Phone (425) 339-8888

13030 121st Way NE
Ste 204
Kirkland, WA 98034
Phone (425) 820-8699

4300 Talbot Rd S
Ste 315
Renton, WA 98055
Phone (206) 719-8451

Interoperability endpoints

  • Direct secure messaging: paris.malin.1@28424.direct.athenahealth.com

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.

Hospital & facility affiliations 2

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": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1104266030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST FL 7",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 HARROUN RD STE 201",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602146",
            "telephone_number": "419-885-5563",
            "fax_number": "419-885-5439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALIN",
        "first_name": "PARIS",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36.003758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO MEDICAL LICENSE",
            "identifier": "36.003758",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

Verify at the official NPI Registry.