Ernest Mall, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

243234 Issued in AZ

Practice address

14068 W Hackamore Dr
Surprise, AZ 85387-1928

Phone

(847) 558-9908

NPI assigned

Feb 21, 2025

Last updated

Feb 21, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ernest.mall@965126828130308.direct.elationemr.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dr. Gregory Carr MD LLC

  • Psychiatry Physician
  • Phoenix, AZ
  • NPI 1386041861
  Medicare reassignment NPD
• Hope and Healing Sanctuary LLC

  • Adult Mental Health Clinic/Center
  • Surprise, AZ
  • NPI 1972413946
  Authorized official Same address or phone

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

{
    "created_epoch": "1740096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1144026998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14068 W HACKAMORE DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853871928",
            "telephone_number": "847-558-9908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14068 W HACKAMORE DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853871928",
            "telephone_number": "847-558-9908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALL",
        "first_name": "ERNEST",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-02-21",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "243234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amardeep Majhail, MD
• Afshin Malaki, MD
• Teresa Dean Malcolm, M.D.
• Omar Maldonado
• Samantha Maldonado
• Elaine Carmella Mamola, RDH
• Jennifer Dianne Man, SLPA
• Alicia Camille Mancini, RPH
• Max Mangabat, DPT
• Tanya Mangini

• Psychiatric/Mental Health Nurse Practitioner in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.