Individual provider Active NPI

Thomas G Malanowski, PA

  • Medical Physician Assistant
  • Little Valley, NY
National Provider Identifier
1275512220
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
000453-1 Issued in NY
Practice address
211 Erie St
Little Valley, NY 14755-1011
Phone
(716) 938-9666
Fax
(716) 938-9668
NPI assigned
Jan 10, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 000453-1 NY Primary

Addresses

Primary practice location

211 Erie St
Little Valley, NY 14755-1011

Mailing address

610 Wayne St
Olean, NY 14760-2355
Phone (716) 372-1570

Other identifiers 1

IdentifierTypeStateIssuer
02471754MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
000453-1NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Olean Medical Group CurrentSince Jan 1, 2015 Accepting new patients
Community Care of Western New York, Inc. Past Accepting new patients

Locations

535 Main St
Olean, NY 14760
Phone (716) 372-0141

610 Wayne St
Olean, NY 14760
Phone (716) 372-1570

449 Broad St
Salamanca, NY 14779
Phone (716) 378-4873

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": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1275512220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 WAYNE ST",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "147602355",
            "telephone_number": "716-372-1570",
            "fax_number": "716-373-2096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 ERIE ST",
            "city": "LITTLE VALLEY",
            "state": "NY",
            "postal_code": "147551011",
            "telephone_number": "716-938-9666",
            "fax_number": "716-938-9668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALANOWSKI",
        "first_name": "THOMAS",
        "middle_name": "G",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "000453-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02471754",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Valley, NY

Sources for this page

Verify at the official NPI Registry.