Individual provider Active NPI

Pattie Jean Malone, MD

  • Family Medicine Physician
  • Whiteriver, AZ
National Provider Identifier
1104832369
Registry record updated Dec 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00044365 Issued in WA
Practice address
200 W. Hospital Drive
Whiteriver, AZ 85941
Phone
(928) 338-4911
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2008

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 MD00044365 WA Primary

Addresses

Primary practice location

200 W. Hospital Drive
Whiteriver, AZ 85941

Mailing address

PO Box 860
Whiteriver, AZ 85941-0860
Phone (928) 338-4911

Other identifiers 5

IdentifierTypeStateIssuer
1629236716MedicaidAZ
1295993376MedicaidAZ
1780614008MedicaidAZ
1871523191MedicaidAZ
962961MedicaidAZ

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100506000682 WA Practitioner - Family Practice 3678598059 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Columbia School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Association of University PhysiciansGroup PAC ID 0446162697, 3,484 clinicians

Practice addresses (Care Compare)

32018 23Rd Ave S
Federal Way, WA 98003-6022
Phone (253) 839-3030

4915 25TH Ave NE 300
Uwnc Ravenna Clinic
Seattle, WA 98105-5668
Phone (206) 525-7777

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.85 of 100Reported as apm
Quality
74.6
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00044365WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Association of University Physicians Family Medicine CurrentSince Mar 1, 2015 Accepting new patients
Dallas Oregon Emergency Physicians LLC PastSince Oct 1, 2023 Accepting new patients

Locations

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

1355 N 205th St
Shoreline, WA 98133
Phone (206) 520-1854

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229299200000",
    "number": "1104832369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860",
            "city": "WHITERIVER",
            "state": "AZ",
            "postal_code": "859410860",
            "telephone_number": "928-338-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W. HOSPITAL DRIVE",
            "city": "WHITERIVER",
            "state": "AZ",
            "postal_code": "85941",
            "telephone_number": "928-338-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONE",
        "first_name": "PATTIE",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2008-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00044365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629236716",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295993376",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780614008",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871523191",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "962961",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whiteriver, AZ

Sources for this page

Verify at the official NPI Registry.