Active NPI
Gerald Oscar Malkin, DDS
- Anesthesiology Physician
- Concord, MA
National Provider Identifier
1265421523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 12001
- Practice address
- 133 Old Road to 9 Acre Cor
Emerson Hospital Department of Anesthesia
Concord, MA 01742-4159 - Phone
- (978) 287-3162
- Fax
- (978) 287-3508
- NPI assigned
- Oct 19, 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 12001 | MA | Primary |
Addresses
Primary practice location
133 Old Road to 9 Acre Cor
Emerson Hospital Department of Anesthesia
Concord, MA 01742-4159
Mailing address
11 Olde Lantern Rd
Acton, MA 01720-2011
Phone (978) 263-3467
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12001 | MA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322611200000",
"number": "1265421523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 OLDE LANTERN RD",
"city": "ACTON",
"state": "MA",
"postal_code": "017202011",
"telephone_number": "978-263-3467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "133 OLD ROAD TO 9 ACRE COR",
"address_2": "EMERSON HOSPITAL DEPARTMENT OF ANESTHESIA",
"city": "CONCORD",
"state": "MA",
"postal_code": "017424159",
"telephone_number": "978-287-3162",
"fax_number": "978-287-3508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALKIN",
"first_name": "GERALD",
"middle_name": "OSCAR",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-19",
"last_updated": "2011-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MA",
"license": "12001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.