Mallory Krkoska, M.S

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

46002979A Issued in IN

Practice address

6437 Rucker Rd
Suite D
Indianapolis, IN 46220-4885

Phone

(317) 405-9016

NPI assigned

Jul 20, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Redwood City, CA
  • NPI 1639252604
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Pediatric Specialty Associates, Inc

  • Early Intervention Provider Agency
  • Indianapolis, IN
  • NPI 1336212638

  Speech-Language Pathologist

  NPD (past)
• Pediatric Specialty Associates, Inc

  • Early Intervention Provider Agency
  • Indianapolis, IN
  • NPI 1346628492
  NPD (past)

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

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1295188795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9959 BUTTONDOWN LN",
            "city": "ZIONSVILLE",
            "state": "IN",
            "postal_code": "460778133",
            "telephone_number": "925-451-9578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6437 RUCKER RD",
            "address_2": "SUITE D",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462204885",
            "telephone_number": "317-405-9016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRKOSKA",
        "first_name": "MALLORY",
        "credential": "M.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-20",
        "last_updated": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "46002979A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3701 Broadway",
            "city": "Oakland",
            "state": "CA",
            "country_code": "US",
            "postal_code": "946115613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alexander Evan Kritikos
• Alexander Kritzer
• Stacy M Kritzmire, DO
• Meredith L Kriz, LMHC
• Margaret Krizon
• Hannah Grace Krodel, LMHC, ATR-BC
• Ashley R Kroeger, MD
• Kathryn Ann Kroeger, M.D.
• Kurt Kroenke, MD
• Elizabeth A Kroepfl, MD

• Speech-Language Pathologist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Speech-Language Pathologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.