Julia Malysh

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

11020165 Issued in FL

Practice address

305 Memorial Medical Pkwy
Daytona Beach, FL 32117-5168

Phone

(386) 615-0900

NPI assigned

Jul 12, 2022

Last updated

Jul 12, 2022By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in FL

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Primecare at Twin Lakes LLCGroup PAC ID 3072591924, 6 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Primecare at Twin Lakes LLC

  • Urgent Care Clinic/Center
  • Daytona Beach, FL
  • NPI 1902809122
  Medicare reassignment Care Compare group NPD
• D.H. Medical, LLC

  • Family Medicine Physician
  • Port Orange, FL
  • NPI 1477855815
  Medicare reassignment NPD
• Advanced Heart Group PL

  dba Advanced Cardiopulmonary & Medical Consultants

  • Cardiovascular Disease Physician
  • Daytona Beach, FL
  • NPI 1720247984
  NPD (past)

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

{
    "created_epoch": "1657584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1356075766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 PATTON PL",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321647546",
            "telephone_number": "904-864-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 MEMORIAL MEDICAL PKWY",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175168",
            "telephone_number": "386-615-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALYSH",
        "first_name": "JULIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-12",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "11020165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mallory Chiropractic Clinic PA (Neck Back & Headache Relief Center)
• David A Mallory, DC
• Katina Mallory
• Shannon Maloney
• Logan Malter
• Stasia Golembiewska Manak, LCSW
• Rebecca Hema Mangali, PA-C
• Patrick Terry Mangonon, MD
• Courtney Mangum, MD
• Marissa N Mangum, APRN

• Family Medicine Physician in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; 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.