Active NPI
Timothy C Malyk, M.D.
- Family Medicine Physician
- Skowhegan, ME
National Provider Identifier
1225035512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD16709
- Practice address
- 46 Fairview Ave Ste 111
Skowhegan, ME 04976-1481 - Phone
- (207) 474-3320
- Fax
- (207) 474-5067
- NPI assigned
- Jul 1, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD16709 | ME | Primary |
Addresses
Primary practice location
46 Fairview Ave Ste 111
Skowhegan, ME 04976-1481
Mailing address
PO Box 468
Skowhegan, ME 04976-0468
Phone (207) 858-8367
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225035512 | Medicaid | ME |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD16709 | ME | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Redington-Fairview General Hospital | Family Medicine | Current | Accepting new patients |
| Redington-Fairview General Hospital | Current | Accepting new patients |
Locations
46 Fairview Ave
Ste 111
Skowhegan, ME 04976
Phone (207) 474-3320
46 Fairview Ave
Ste 111B
Skowhegan, ME 04976
46 Fairview Ave
Skowhegan, ME 04976
Phone 2074745121293
Interoperability endpoints
- timothy.malyk@rfp.direct.rfgh.net
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.
-
- Critical Access Hospital
- Skowhegan, ME
- NPI 1174549133
-
- Rural Health Clinic/Center
- Madison, ME
- NPI 1851423008
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688083200000",
"number": "1225035512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 468",
"city": "SKOWHEGAN",
"state": "ME",
"postal_code": "049760468",
"telephone_number": "207-858-8367",
"fax_number": "207-474-9261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "46 FAIRVIEW AVE STE 111",
"city": "SKOWHEGAN",
"state": "ME",
"postal_code": "049761481",
"telephone_number": "207-474-3320",
"fax_number": "207-474-5067"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALYK",
"first_name": "TIMOTHY",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-01",
"last_updated": "2023-06-30",
"certification_date": "2023-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ME",
"license": "MD16709",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1225035512",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Skowhegan, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; 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.