Thomas a Malec MD PC

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

4301026401 Issued in MI

Legal business name

THOMAS A MALEC MD PC

Practice address

515 Lakeside Dr SE
Suite 207
Grand Rapids, MI 49506-2931

Phone

(616) 459-3564

Fax

(616) 459-3868

NPI assigned

Apr 17, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Thomas Anthony Malec, M.D.NPI 1619961778

Title

President of Corporation

Phone

(616) 459-3564

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas A Malec, M.D., P.C.

  • Ophthalmology Physician
  • Grand Rapids, MI
  • NPI 1619961778
  NPD (past) Authorized official

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

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219881600000",
    "number": "1346414620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 LAKESIDE DR SE",
            "address_2": "SUITE 207",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495062931",
            "telephone_number": "616-459-3564",
            "fax_number": "616-459-3868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 LAKESIDE DR SE",
            "address_2": "SUITE 207",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495062931",
            "telephone_number": "616-459-3564",
            "fax_number": "616-459-3868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS A MALEC MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-17",
        "last_updated": "2008-08-28",
        "status": "A",
        "authorized_official_last_name": "MALEC",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT OF CORPORATION",
        "authorized_official_telephone_number": "616-459-3564",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "MI",
            "license": "4301026401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101059530",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Third Coast Counseling Center
• Third Coast Health
• Thistle and Fern Wellness LLC
• Timothy Thoits, MD
• Kaelyn Elise Rayne Thoman
• Thomas J. Harmon D.D.S.
• Thomas P. Dunning O.D., P.C.
• Anne E Thomas, N.P.
• Atiras Thomas
• Christopher Alan Thomas II

• Exclusive Provider Organization in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Exclusive Provider Organization in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2008; 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.