Individual provider Active NPI

Raymond George Malackany, DO

  • Pain Medicine (Anesthesiology) Physician
  • Youngstown, OH
National Provider Identifier
1174518203
Registry record updated Oct 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
34002718 Issued in OH
Practice address
3622 Belmont Ave
Suite1
Youngstown, OH 44505-1450
Phone
(330) 759-9350
Fax
(330) 759-9387
NPI assigned
Sep 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 34002718M OH
Pain Medicine (Anesthesiology) Physician 207LP2900X 34002718 OH Primary

Addresses

Primary practice location

3622 Belmont Ave
Suite1
Youngstown, OH 44505-1450

Mailing address

3622 Belmont Ave
Suite1
Youngstown, OH 44505-1450
Phone (330) 759-9350

Other identifiers 1

IdentifierTypeStateIssuer
0376374MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34002718MOHMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Anesthesiologists, Inc. Anesthesiology Past Accepting new patients
Advanced Anesthesia Associates,Inc Anesthesiology Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288137600000",
    "number": "1174518203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3622 BELMONT AVE",
            "address_2": "SUITE1",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445051450",
            "telephone_number": "330-759-9350",
            "fax_number": "330-759-9387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3622 BELMONT AVE",
            "address_2": "SUITE1",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445051450",
            "telephone_number": "330-759-9350",
            "fax_number": "330-759-9387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALACKANY",
        "first_name": "RAYMOND",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2010-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "34002718M",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "OH",
            "license": "34002718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0376374",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.