Thomas Mark Mamalakis, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0024181685 Issued in VA

Practice address

2305 N Parham Rd Ste 3
Richmond, VA 23229-3156

Phone

(804) 270-1124

NPI assigned

Jun 24, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

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

University of Virginia School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dominion Behavioral HealthcareGroup PAC ID 6709803570, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Dominion Behavioral Healthcare

  • Clinical Psychologist
  • Richmond, VA
  • NPI 1043262215
  Medicare reassignment Care Compare group NPD
• Dominion Behavioral Healthcare

  • Mental Health Counselor
  • Richmond, VA
  • NPI 1427075449
  NPD

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

{
    "created_epoch": "1624492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1346810173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 N PARHAM RD STE 3",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232293156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 N PARHAM RD STE 3",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232293156",
            "telephone_number": "804-270-1124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMALAKIS",
        "first_name": "THOMAS",
        "middle_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-24",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024181685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA BOARD OF NURSING LICENSE",
            "identifier": "0024181685",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Asimina Phillos Malovrh, PHARMD
• William Victor Maloy, L.P.C.
• Stephanie Malozzi, PHD
• Zenaida Cepe Malpaya
• Mama Rees Child Development Center
• Janice Manalo, CRNA
• Amber N Manche
• Manchester Pediatric Associates, PC
• Manchester Physical Therapy, Inc
• Anthony Michael Mancini, PH.D.

• Psychiatric/Mental Health Nurse Practitioner in Richmond, VA
• Providers in Richmond, VA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; 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.