Individual provider Active NPI

Mary Patricia Malitas, CRNP

  • Nurse Practitioner
  • Pomona, NJ
National Provider Identifier
1265756530
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ01110500 Issued in NJ
Practice address
65 W Jimmie Leeds Rd
Pomona, NJ 08240-9102
Phone
(609) 748-7089
Fax
(609) 652-3460
NPI assigned
Mar 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X VP003532P PA
Nurse Practitioner 363L00000X 26NJ01110500 NJ Primary

Addresses

Primary practice location

65 W Jimmie Leeds Rd
Pomona, NJ 08240-9102

Mailing address

65 W Jimmie Leeds Rd
Pomona, NJ 08240-9102
Phone (609) 748-7089

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130524000037 PA Practitioner - Nurse Practitioner 6800034208 Reassigns benefits to 2 organizations
I20260520004539 NJ Practitioner - Nurse Practitioner 6800034208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, shared by 15 NPIs, 3,433 clinicians

Practice addresses (Care Compare)

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 662-2050

51 N 39TH St HVP 2ND FL
Div of Cardiology
Philadelphia, PA 19104-2640
Phone (215) 662-9010

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NJ01110500NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group CurrentSince Mar 13, 2017 Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
University of Penn-Medical Group Current Accepting new patients

Locations

51 N 39th St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-9010

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

3400 Spruce St
Fl 9
Philadelphia, PA 19104
Phone (215) 662-2891

800 Walnut St
Fl 20
William Penn Annex West, PA 19107
Phone (215) 829-2092

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 3

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": "1268697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778112000000",
    "number": "1265756530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 W JIMMIE LEEDS RD",
            "city": "POMONA",
            "state": "NJ",
            "postal_code": "082409102",
            "telephone_number": "609-748-7089",
            "fax_number": "609-652-3460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 W JIMMIE LEEDS RD",
            "city": "POMONA",
            "state": "NJ",
            "postal_code": "082409102",
            "telephone_number": "609-748-7089",
            "fax_number": "609-652-3460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALITAS",
        "first_name": "MARY",
        "middle_name": "PATRICIA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-16",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "VP003532P",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ01110500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, NJ

Sources for this page

Verify at the official NPI Registry.