Individual provider Active NPI

Craig Malcolm, PHD

  • Clinical Neuropsychologist
  • Wellfleet, MA
National Provider Identifier
1245388701
Registry record updated Jul 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
6731 Issued in MA
Practice address
2700 State Highway, Route 6
Unit 2
Wellfleet, MA 02667
Phone
(508) 905-2434
Fax
(508) 905-2855
NPI assigned
Jan 8, 2007
Last updated
Jul 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 6731 MA Primary

Addresses

Primary practice location

2700 State Highway, Route 6
Unit 2
Wellfleet, MA 02667

Mailing address

PO Box 2796
Orleans, MA 02653-6796
Phone (508) 432-1400

Other identifiers 1

IdentifierTypeStateIssuer
110023854AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050216000174 MA Practitioner - Clinical Psychologist 1355393539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Outer Cape Health Services IncGroup PAC ID 4385554971, 51 clinicians

Practice addresses (Care Compare)

49 Harry Kemp Way
Provincetown, MA 02657-1618
Phone (508) 487-9395

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Outer Cape Health Services, Inc. CurrentSince Jun 30, 2023 Accepting new patients
Outer Cape Health Services, Inc. CurrentSince Jun 30, 2023 Accepting new patients

Locations

49 Harry Kemp Way
Provincetown, MA 02657
Phone (508) 487-9395

3130 State Hwy Rte 6
Wellfleet, MA 02667
Phone (508) 349-3131

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785369600000",
    "number": "1245388701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2796",
            "city": "ORLEANS",
            "state": "MA",
            "postal_code": "026536796",
            "telephone_number": "508-432-1400",
            "fax_number": "508-487-6298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 STATE HIGHWAY, ROUTE 6",
            "address_2": "UNIT 2",
            "city": "WELLFLEET",
            "state": "MA",
            "postal_code": "02667",
            "telephone_number": "508-905-2434",
            "fax_number": "508-905-2855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALCOLM",
        "first_name": "CRAIG",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MA",
            "license": "6731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110023854A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellfleet, MA

Sources for this page

Verify at the official NPI Registry.