Jedidiah Jonah Malan, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

6326 Issued in AK

Practice address

815 2ND Ave
Suite 202
Fairbanks, AK 99701-4400

Phone

(316) 519-7664

NPI assigned

May 1, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Radiology Consultants a Professional Corp

  • Diagnostic Radiology Physician
  • Fairbanks, AK
  • NPI 1124056734
  NPD (past)
• Arizona Diagnostic Radiology Group, LLC

  • Diagnostic Radiology Physician
  • Gilbert, AZ
  • NPI 1336757699
  NPD (past)

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1396966040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ALASKA RADIOLOGY ASSOCIATES",
            "address_2": "3650 PIPER ST, STE A",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99508",
            "telephone_number": "316-519-7664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 2ND AVE",
            "address_2": "SUITE 202",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014400",
            "telephone_number": "316-519-7664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALAN",
        "first_name": "JEDIDIAH",
        "middle_name": "JONAH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD60225585",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KS",
            "license": "6347",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AK",
            "license": "6326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rene Majors
• Stephanie Majors
• Making a Difference Support Services
• Making a Difference Support Services, LLC
• Liza Sarah Malamute, RN, CDE, CFCN
• Sara DB Malenfant, LMT
• Alejandrina Maria Mallet, RBT
• Kathryn Chatterton Mallory, LPS
• Christine M. Malone, RN, BSN, MSPH
• Natosha Malone, MSW

• Diagnostic Radiology Physician in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Diagnostic Radiology Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.