NPIMap

Individual provider Active NPI

Gregory Charles Mallo, M.D.

  • Orthopaedic Surgery Physician
  • East Setauket, NY
National Provider Identifier
1245412295
Registry record updated Nov 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
280603 Issued in NY
Practice address
6 Technology Dr 100
East Setauket, NY 11733-4079
Phone
(631) 689-6698
Fax
(631) 751-5548
NPI assigned
Dec 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 280603 NY Primary

Addresses

Primary practice location

6 Technology Dr 100
East Setauket, NY 11733-4079

Mailing address

6 Technology Dr 100
East Setauket, NY 11733-4079
Phone (631) 689-6698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150831000103 NY Practitioner - Orthopedic Surgery 7315179983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Jefferson Medical College of Thomas Jefferson University, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
True North Medical Group PCGroup PAC ID 7012194806, 185 clinicians

Practice addresses (Care Compare)

686 County Route
39A
Southampton, NY 11968-5703
Phone (631) 283-0355

Hospital & facility affiliations

  • Peconic Bay Homehealth Services Home health agency, Riverhead, NY, CCN 337400
  • John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185
  • St Charles Hospital Hospital, Port Jefferson, NY, CCN 330246
  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)144

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
280603NYMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
True North Medical Group PC Orthopaedic Surgery CurrentSince Aug 21, 2019 Accepting new patients
Orthopedic Associates of Long Island LLP Orthopaedic Surgery CurrentSince Sep 1, 2015 Accepting new patients
True North Medical Group PC Orthopaedic Surgery CurrentSince Aug 21, 2019 Accepting new patients
True North Medical Group PC Past Accepting new patients

Locations

3480 Veterans Memorial Hwy
Bohemia, NY 11716
Phone (631) 289-0338

6 Technology Dr
Ste 100
East Setauket, NY 11733
Phone (631) 371-2685

75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320

36 Lincoln Ave
Fl 3
Rockville Ctr, NY 11570

222 E Middle Country Rd
Ste 340
Smithtown, NY 11787
Phone (631) 360-6370

222 E Middle Country Rd
Ste 108
Smithtown, NY 11787
Phone (631) 706-2800

686 County Road 39A
Southampton, NY 11968
Phone (631) 283-0355

Interoperability endpoints

  • Direct secure messaging: gregorymallo@nslijmedgr.allscriptsdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1196467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447804800000",
    "number": "1245412295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 TECHNOLOGY DR 100",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117334079",
            "telephone_number": "631-689-6698",
            "fax_number": "631-751-5548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 TECHNOLOGY DR 100",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117334079",
            "telephone_number": "631-689-6698",
            "fax_number": "631-751-5548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLO",
        "first_name": "GREGORY",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-01",
        "last_updated": "2015-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "280603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.