NPIMap

Individual provider Active NPI

Michael Malin, MD

  • Diagnostic Radiology Physician
  • Southbury, CT
National Provider Identifier
1275565640
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
034220 Issued in CT
Practice address
385 Main St S
Union Square
Southbury, CT 06488-4240
Phone
(203) 264-7999
Fax
(203) 264-7477
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Radiology Physician 2085N0904X 034220 CT
Diagnostic Ultrasound Physician 2085U0001X 034220 CT
Diagnostic Radiology Physician 2085R0202X 034220 CT Primary

Addresses

Primary practice location

385 Main St S
Union Square
Southbury, CT 06488-4240

Mailing address

385 Main St S
Union Square BLDG #1 C O Nvra Imaging Network
Southbury, CT 06488-4240
Phone (203) 264-7999

Other identifiers 1

IdentifierTypeStateIssuer
001342203MedicaidCT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmalin222471@direct.stfranciscare.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20040324000842 CT Practitioner - Diagnostic Radiology 0244121887 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diagnostic Imaging Associates LLC 10 clinicians
Prospect Diagnostic Imaging 10 clinicians
Naugatuck Valley Radiological Associates PC 12 clinicians

Practice addresses (Care Compare)

1389 W Main St
Waterbury, CT 06708-3115
Phone (203) 574-1311

166 Waterbury Rd
Prospect, CT 06712-1200
Phone (203) 758-7700

385 Main St S
BLDG 1
Southbury, CT 06488-4246
Phone (203) 267-5114

Hospital & facility affiliations

  • Saint Mary'S Hospital Hospital, Waterbury, CT, CCN 070016
  • Griffin Hospital Hospital, Derby, CT, CCN 070031
  • Waterbury Hospital Hospital, Waterbury, CT, CCN 070005
  • St Francis Hospital & Medical Center Hospital, Hartford, CT, CCN 070002
  • Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
034220CTMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Imaging Associates LLC CurrentSince Jan 2, 1998 Accepting new patients
Naugatuck Valley Radiological Associates PC Diagnostic Radiology CurrentSince May 1, 1997 Accepting new patients
The Harold Leever Regional Cancer Center Inc CurrentSince Sep 1, 2001 Accepting new patients
Naugatuck Valley MRI LLC Diagnostic Radiology CurrentSince Apr 4, 2010 Accepting new patients
Diagnostic Imaging of Southbury CurrentSince Jan 1, 1999 Accepting new patients
Prospect Diagnostic Imaging CurrentSince May 1, 2002 Accepting new patients
Naugatuck Valley Computerized Imaging Past Accepting new patients
Health Imaging Associates Past Accepting new patients

Locations

166 Waterbury Rd
Prospect, CT 06712
Phone (203) 264-7999

385 Main St S
Southbury, CT 06488
Phone (203) 264-7999

385 Main St S
Bldg 1
Southbury, CT 06488
Phone (203) 264-7999

1389 W Main St
Waterbury, CT 06708
Phone (203) 264-7999

Organizations & group practices 8

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 8

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1275565640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 MAIN ST S",
            "address_2": "UNION SQUARE BLDG #1 C O NVRA IMAGING NETWORK",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064884240",
            "telephone_number": "203-264-7999",
            "fax_number": "203-264-7477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 MAIN ST S",
            "address_2": "UNION SQUARE",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064884240",
            "telephone_number": "203-264-7999",
            "fax_number": "203-264-7477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALIN",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "CT",
            "license": "034220",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "CT",
            "license": "034220",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CT",
            "license": "034220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001342203",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmalin222471@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "Trinity Health of New England Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "385 Main St S",
            "address_2": "Union Square",
            "city": "Southbury",
            "state": "CT",
            "country_code": "US",
            "postal_code": "064884240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Southbury, CT

Sources for this page

Verify at the official NPI Registry.