Individual provider Active NPI

Mark E O'Malley, D.C.

  • Chiropractor
  • Wethersfield, CT
National Provider Identifier
1184736043
Registry record updated Nov 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CT000731 Issued in CT
Practice address
78 Beaver Rd
Suite 2a
Wethersfield, CT 06109-2295
Phone
(860) 257-9400
Fax
(860) 257-7169
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CT000731 CT Primary

Addresses

Primary practice location

78 Beaver Rd
Suite 2a
Wethersfield, CT 06109-2295

Mailing address

78 Beaver Rd
Suite 2a
Wethersfield, CT 06109-2295
Phone (860) 257-9400

Other identifiers 5

IdentifierTypeStateIssuer
682637OtherCTCONNECTICARE
2V2010OtherCTHEALTHNET
050000731CT01OtherCTANTHEM BLUE CROSS
519710OtherCTAETNA
4590708OtherCTENVOY/AETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111123000129 CT Practitioner - Chiropractic 7113191495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

78 Beaver Rd
Suite 1a
Wethersfield, CT 06109-2200
Phone (860) 257-9400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CT000731CTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Josephine Contrino MD, LLC CurrentSince Oct 19, 2016 Accepting new patients
O'Malley Chiropractic Health Center, LLC Chiropractor CurrentSince Sep 28, 2011 Accepting new patients

Locations

78 Beaver Rd
Ste 2A
Wethersfield, CT 06109
Phone (860) 257-9400

78 Beaver Rd
Ste 1A
Wethersfield, CT 06109
Phone (860) 257-9400

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290038400000",
    "number": "1184736043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 BEAVER RD",
            "address_2": "SUITE 2A",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061092295",
            "telephone_number": "860-257-9400",
            "fax_number": "860-257-7169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 BEAVER RD",
            "address_2": "SUITE 2A",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061092295",
            "telephone_number": "860-257-9400",
            "fax_number": "860-257-7169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'MALLEY",
        "first_name": "MARK",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2010-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "CT000731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "682637",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2V2010",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "050000731CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "519710",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ENVOY/AETNA",
            "identifier": "4590708",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wethersfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.