Samantha Malm, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

A89453 Issued in CA

Practice address

2500 Milvia St
Berkeley, CA 94704

Phone

(510) 204-5600

Fax

(510) 204-5462

NPI assigned

Jan 10, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Sutter Bay Medical Foundation

  • Multi-Specialty Clinic/Center
  • Palo Alto, CA
  • NPI 1013950807
  Medicare reassignment NPD
• Sutter Bay Medical Foundation

  • Clinical Medical Laboratory
  • Santa Clara, CA
  • NPI 1669287033
  NPD

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1396724266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "510-204-5600",
            "fax_number": "510-204-5462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 MILVIA ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94704",
            "telephone_number": "510-204-5600",
            "fax_number": "510-204-5462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2850 Telegraph Ave",
            "address_2": "Ste. #130",
            "address_purpose": "LOCATION",
            "city": "Berkeley",
            "state": "CA",
            "postal_code": "947051192",
            "country_code": "US",
            "telephone_number": "510-204-8110 x8172",
            "fax_number": "510-843-0804",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3687 Mt Diablo Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "CA",
            "postal_code": "945493746",
            "country_code": "US",
            "telephone_number": "866-681-0745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALM",
        "first_name": "SAMANTHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A89453",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A89453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "A89453",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra Maldonado
• Akshiv Malhotra, MD
• Anushree Malhotra
• Zainub Mallick
• Nirmala S Mallipatna, MS
• Kathryn Emily Malone, MD
• Abigail Anne Casem Mamaril, PHARMD
• Melanie Manaku
• Michael J Manansala, MD
• Maria-Laura Mancianti, MD

• Anatomic Pathology & Clinical Pathology Physician in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Anatomic Pathology & Clinical Pathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.