Mario Supan Malonzo, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

152890 Issued in NY

Practice address

1012 E Gun Hill Rd
Bronx, NY 10469-3720

Phone

(718) 918-8850

NPI assigned

Jun 14, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: mmalonzo835944@nychhc.direct-ci.com

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.

• New York City Health and Hospitals Corporation

  • Clinic/Center
  • New York, NY
  • NPI 1548208127
  Medicare reassignment NPD
• Dr. Mario S. Malonzo, M.D., P.C.

  • Pediatrics Physician
  • Bronx, NY
  • NPI 1033297338
  NPD (past) Authorized official
• New York City Health and Hospitals Corporation

  • Clinic/Center
  • Brooklyn, NY
  • NPI 1356406136
  NPD
• New York City Health and Hospitals Corporation

  • Clinic/Center
  • New York, NY
  • NPI 1538943469
  NPD

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144424862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 WALWORTH AVE",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105831423",
            "telephone_number": "914-725-0751",
            "fax_number": "914-722-1730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 E GUN HILL RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104693720",
            "telephone_number": "718-918-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONZO",
        "first_name": "MARIO",
        "middle_name": "SUPAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "152890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00898540",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michele Malone
• Robyn Malone, DDS
• Kyle Maloney, MD
• Meghan Christine Maloney, M.D.
• Susan Maloney, LCSW, CASAC
• Marcoantonio Malpica
• Hannah Malter
• Avery Maltman
• Shermaine Batara Malto, PT
• Sabrina Malvoisin

• Pediatrics Physician in Bronx, NY
• Providers in Bronx, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.