Jean Marie Malsack, MS ACNP-BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

R172115 Issued in MD

Practice address

301 Hospital Dr
Glen Burnie, MD 21061

Phone

(410) 787-4000

NPI assigned

Jun 21, 2011

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 MD

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Master of Science

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.

• Baltimore Washington Medical Center Inc.

  • General Acute Care Hospital
  • Glen Burnie, MD
  • NPI 1124016696
  Medicare reassignment NPD
• University of Maryland Community Medical Group, Inc.

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1477530624
  Medicare reassignment

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

{
    "created_epoch": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534118400000",
    "number": "1366738114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 ELKRIDGE LANDING RD",
            "city": "LINTHICUM",
            "state": "MD",
            "postal_code": "210902917",
            "telephone_number": "443-462-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HOSPITAL DR",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "21061",
            "telephone_number": "410-787-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALSACK",
        "first_name": "JEAN",
        "middle_name": "MARIE",
        "credential": "MS ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-21",
        "last_updated": "2018-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MD",
            "license": "R172115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salman M Malik, M.D.
• Shahab Malik, MD
• Darlene Maria Malley, COTA/L
• Domonique Malloy, LCPC
• Elizabeth Malott, OTR/L
• Alif Manejwala, MD
• Jennifer Ann Mangold, R.N.
• Aliesha Nicole Mann, CRNP
• Arif Mannan, M.D.
• Himabindu Manneri, M.D

• Acute Care Nurse Practitioner in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Acute Care Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.