Cary Lynn Malstaff

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71007185A Issued in IN

Practice address

1007 Lincolnway
La Porte, IN 46350-3201

Phone

(219) 326-2300

NPI assigned

Jun 26, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Bend Emergency Physicians IncGroup PAC ID 0941282354, 51 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital of South Bend Hospital, South Bend, IN, CCN 150058

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• South Bend Emergency Physicians, Inc

  • Emergency Medicine Physician
  • South Bend, IN
  • NPI 1487132114
  Medicare reassignment Care Compare group NPD
• North Indiana Emergency Physicians, LLP

  • Emergency Medicine Physician
  • La Porte, IN
  • NPI 1144691478
  Medicare reassignment NPD
• Pic Indiana PC

  • Urgent Care Clinic/Center
  • Mishawaka, IN
  • NPI 1942546890
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Memorial Hospital of South Bend

  • General Acute Care Hospital
  • South Bend, IN
  • NPI 1295772093
  Care Compare affiliation
• Memorial Hospital of South Bend

  • Psychiatric Hospital Unit
  • South Bend, IN
  • NPI 1376841395
  Care Compare affiliation
• Memorial Hospital of South Bend

  • General Acute Care Hospital
  • Granger, IN
  • NPI 1881177756
  Care Compare affiliation

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

{
    "created_epoch": "1498435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498435200000",
    "number": "1346760873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 GRISSOM DR",
            "city": "WALKERTON",
            "state": "IN",
            "postal_code": "465741002",
            "telephone_number": "574-309-6226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 LINCOLNWAY",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463503201",
            "telephone_number": "219-326-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALSTAFF",
        "first_name": "CARY",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-26",
        "last_updated": "2017-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "281506A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71007185A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in La Porte, IN
• Providers in La Porte, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.