Individual provider Active NPI

Michael Malone, DO

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1164508263
Registry record updated Feb 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-103685 Issued in IL
Practice address
5159 S. Ashland Ave
Chicago, IL 60609-5322
Phone
(773) 434-9216
Fax
(773) 434-2670
NPI assigned
Oct 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2014

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 036-103685 IL Primary

Addresses

Primary practice location

5159 S. Ashland Ave
Chicago, IL 60609-5322

Mailing address

5050 S State St
Chicago, IL 60609-5302
Phone (773) 924-5898

Other identifiers 1

IdentifierTypeStateIssuer
036103685MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20040512000648 IL Practitioner - Family Practice 0244229300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Chicago College of Osteopathy, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mount Sinai Community FoundationGroup PAC ID 5991600405, 247 clinicians

Practice addresses (Care Compare)

1401 S California Ave
Chicago, IL 60608-1858
Phone (773) 522-6656

2701 W 68TH St
Chicago, IL 60629-1813
Phone (773) 884-9000

California Ave at 15TH St
Chicago, IL 60608-1858
Phone (773) 542-2000

Hospital & facility affiliations

  • Holy Cross Hospital Hospital, Chicago, IL, CCN 140133
  • Mt Sinai Hospital Medical Center Hospital, Chicago, IL, CCN 140018
  • Schwab Rehabilitation Hospital Inpatient rehabilitation facility, Chicago, IL, CCN 143025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-103685ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai Community Foundation Current Accepting new patients
Mount Sinai Community Foundation CurrentSince Dec 1, 2012 Accepting new patients
Mount Sinai Community Foundation CurrentSince Dec 1, 2012 Accepting new patients

Locations

2701 W 68th St
Chicago, IL 60629
Phone (773) 471-8000

26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900

5050 S State St
Chicago, IL 60609
Phone (773) 257-1110

1501 S California Ave
#7140
Chicago, IL 60608
Phone (773) 257-4758

Organizations & group practices 3

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 6

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": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392076800000",
    "number": "1164508263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 S STATE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606095302",
            "telephone_number": "773-924-5898",
            "fax_number": "773-924-5791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5159 S. ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606095322",
            "telephone_number": "773-434-9216",
            "fax_number": "773-434-2670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONE",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2014-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-103685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036103685",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.