Fallon H Maylack, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

R5E50 Issued in MO

Practice address

12255 De Paul Dr
Ste 845
Bridgeton, MO 63044-2510

Phone

(314) 884-6320

Fax

(314) 884-6321

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

No

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 MO

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

Specialty

Orthopedic Surgery

Education

Washington University School of Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

American Multispecialty Group IncGroup PAC ID 1658365572, 118 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Evertrue Home Health Home health agency, St. Louis, MO, CCN 267530
• SSM Health Depaul Hospital St Louis Hospital, Bridgeton, MO, CCN 260104

Merit-based Incentive Payment System (MIPS)

Final score

86.37 of 100Reported as group

Quality

79.66

Promoting interoperability

98

Improvement activities

40

Cost

76.57

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: fallon.maylack.p1@direct.essehealth.nextgenshare.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.

• American Multispecialty Group Inc.

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1972559532
  Medicare reassignment Care Compare group
• SSM Depaul Medical Group, Inc.

  • Family Medicine Physician
  • Florissant, MO
  • NPI 1952312951
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lutheran Senior Services

  • Home Health Agency
  • Saint Louis, MO
  • NPI 1770664161
  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Bridgeton, MO
  • NPI 1598835308
  Care Compare affiliation

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486944000000",
    "number": "1184642993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23340",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631563340",
            "telephone_number": "314-884-6320",
            "fax_number": "314-884-6321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12255 DE PAUL DR",
            "address_2": "STE 845",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442510",
            "telephone_number": "314-884-6320",
            "fax_number": "314-884-6321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYLACK",
        "first_name": "FALLON",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2017-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "R5E50",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207746702",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Mathis, MSN,APRN, FNP-BC
• Richard Anthony Matkowski
• Melanie Matthew, LMSW
• Susan Mattie, RPH
• Daniel T Mattson, MD
• MBCH Children and Family Ministries
• MBCH Children and Family Ministries
• Amy Elizabeth McAlister, PNP
• Melissa Renee McBride, PHARMD
• Joseph McCarthy

• Orthopaedic Surgery Physician in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Orthopaedic Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; 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.