Individual provider Active NPI

Ryan Paul Malburg II, PA-C

  • Physician Assistant
  • Mesa, AZ
National Provider Identifier
1104599265
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9664 Issued in AZ
Practice address
1500 S Dobson Rd Ste 202
Mesa, AZ 85202-4724
Phone
(866) 974-2673
Fax
(866) 939-2673
NPI assigned
Jul 26, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9664 AZ Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1500 S Dobson Rd Ste 202
Mesa, AZ 85202-4724

Mailing address

18444 N 25TH Ave Ste 310
Phoenix, AZ 85023-1266
Phone (866) 974-2673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230512000617 AZ Practitioner - Physician Assistant 5991161267 Reassigns benefits to 1 organization
I20241231003387 MI Practitioner - Physician Assistant 5991161267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of South Alabama College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

1670 E Sherman Blvd
Suite 100
Muskegon, MI 49444-1863
Phone (231) 672-3600

2006 Holton Rd
Suite 500
Muskegon, MI 49445-1505
Phone (231) 370-1280

2305 Genoa Bus Park Dr
Brighton, MI 48114-7005

Hospital & facility affiliations

  • Trinity Health Muskegon Hospital Hospital, Muskegon, MI, CCN 230066

Merit-based Incentive Payment System (MIPS)

Final score
85.65 of 100Reported as group
Quality
76.23
Promoting interoperability
100
Improvement activities
40
Cost
75.95

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9664AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Service Corporation CurrentSince Dec 9, 2024 Accepting new patients
Center for Orthopedic Research and Education, LLC Physician Assistant CurrentSince May 15, 2023 Accepting new patients
Iha Health Services Corporation CurrentSince Dec 9, 2024 Accepting new patients

Locations

3591 S Mercy Rd
Ste 204
Gilbert, AZ 85297
Phone (869) 742-6736

1500 S Dobson Rd
Ste 202
Mesa, AZ 85202
Phone (866) 974-2676

18444 N 25th Ave
Ste 210
Phoenix, AZ 85023
Phone (669) 742-6738

18444 N 25th Ave
Ste 310
Phoenix, AZ 85023
Phone (623) 241-8706

10494 W Thunderbird Blvd
Ste 102
Sun City, AZ 85351
Phone (623) 975-8311

2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

Interoperability endpoints

  • Direct secure messaging: rmalburg3788134@direct.trinity-health.org

Organizations & group practices 4

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 1

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": "1627257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1104599265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18444 N 25TH AVE STE 310",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850231266",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S DOBSON RD STE 202",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024724",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALBURG",
        "first_name": "RYAN",
        "middle_name": "PAUL",
        "name_suffix": "II",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-26",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9664",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.