Individual provider Active NPI

Chad M Maloney, O.D.

  • Optometrist
  • Shelby TWP, MI
National Provider Identifier
1285863027
Registry record updated Apr 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901003027 Issued in MI
Practice address
52799 Hayes Rd
Shelby TWP, MI 48315-2522
Phone
(586) 247-2652
Fax
(586) 247-4483
NPI assigned
Jul 14, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901003027 MI Primary

Addresses

Primary practice location

52799 Hayes Rd
Shelby TWP, MI 48315-2522

Mailing address

118 Cass Ave
Mount Clemens, MI 48043-2204
Phone (586) 464-1479

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121220000227 MI Practitioner - Optometry 4082760996 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523750400000",
    "number": "1285863027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 CASS AVE",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432204",
            "telephone_number": "586-464-1479",
            "fax_number": "586-464-1480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52799 HAYES RD",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483152522",
            "telephone_number": "586-247-2652",
            "fax_number": "586-247-4483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONEY",
        "first_name": "CHAD",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-14",
        "last_updated": "2018-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby TWP, MI

Sources for this page

Verify at the official NPI Registry.