Individual provider Active NPI

Bozena Krystyna Malyszko, M.D.

  • Internal Medicine Physician
  • Wallingford, CT
National Provider Identifier
1316112279
Registry record updated Jun 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
233797 Issued in MA
Practice address
50 Gaylord Farm Rd
Wallingford, CT 06492-2828
Phone
(203) 284-2800
Fax
(203) 294-8705
NPI assigned
Apr 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 233797 MA Primary

Addresses

Primary practice location

50 Gaylord Farm Rd
Wallingford, CT 06492-2828

Mailing address

20 York Street, CB-329
New Haven, CT 06510-3220
Phone (203) 688-1734

Other practice location 1

715 Albany St
R304
Boston, MA 02118-2526
Phone (617) 638-4860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190917002278 CT Practitioner - Internal Medicine 2567633530 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Georgetown University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

267 Grant St
Bridgeport, CT 06610-2805
Phone (203) 384-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.54
Promoting interoperability
99.98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
233797MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. Internal Medicine CurrentSince Aug 5, 2019 Accepting new patients
Quarry Road Emergency Services P.C. Past Accepting new patients
Steward Norwood Hospital, Inc. Past Accepting new patients

Locations

267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3170

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

50 Gaylord Farm Rd
Wallingford, CT 06492
Phone (203) 679-3553

Interoperability endpoints

  • Direct secure messaging: bmalyszko18756@sbhny.direct-ci.net

Organizations & group practices 3

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 5

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": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591660800000",
    "number": "1316112279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK STREET, CB-329",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-1734",
            "fax_number": "203-294-8705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 GAYLORD FARM RD",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922828",
            "telephone_number": "203-284-2800",
            "fax_number": "203-294-8705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "715 Albany St",
            "address_2": "R304",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021182526",
            "country_code": "US",
            "telephone_number": "617-638-4860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALYSZKO",
        "first_name": "BOZENA",
        "middle_name": "KRYSTYNA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-22",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "233797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

Verify at the official NPI Registry.