Individual provider Active NPI

Mallory Jones, PA-C

  • Physician Assistant
  • Algonquin, IL
National Provider Identifier
1285136382
Registry record updated Mar 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.006519 Issued in IL
Practice address
2430 Esplanade Dr Ste B
Algonquin, IL 60102-5500
Phone
(847) 458-7546
Fax
(224) 333-3436
NPI assigned
Mar 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.006519 IL Primary

Addresses

Primary practice location

2430 Esplanade Dr Ste B
Algonquin, IL 60102-5500

Mailing address

2430 Esplanade Dr Ste B
Algonquin, IL 60102-5500
Phone (847) 458-7546

Other identifiers 1

IdentifierTypeStateIssuer
085.006519OtherILIL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20180326002119 IL Practitioner - Physician Assistant 8022370394 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Saint Louis University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Specialists of Illinois, LTDGroup PAC ID 7517288236, 10 clinicians

Practice addresses (Care Compare)

2430 Esplanade Dr
Suite B
Algonquin, IL 60102-5500
Phone (847) 458-7546

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

Merit-based Incentive Payment System (MIPS)

Final score
89.6 of 100Reported as group
Quality
87.74
Promoting interoperability
100
Improvement activities
40
Cost
77.61

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085.006519ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Algonquin Family Chiropractic LTD. PastSince Sep 12, 2016 Accepting new patients

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1520208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520208000000",
    "number": "1285136382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2430 ESPLANADE DR STE B",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601025500",
            "telephone_number": "847-458-7546",
            "fax_number": "224-333-3436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 ESPLANADE DR STE B",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601025500",
            "telephone_number": "847-458-7546",
            "fax_number": "224-333-3436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "MALLORY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-05",
        "last_updated": "2018-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.006519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL LICENSE",
            "identifier": "085.006519",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Algonquin, IL

Sources for this page

Verify at the official NPI Registry.