Individual provider Active NPI

Maureen Ann Malone, ANP-C

  • Adult Health Nurse Practitioner
  • Smithtown, NY
National Provider Identifier
1407015654
Registry record updated Jun 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
304441 Issued in NY
Practice address
50 Route 25a
Smithtown, NY 11787-1348
Phone
(631) 862-3000
NPI assigned
Jun 3, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 304441 NY Primary

Addresses

Primary practice location

50 Route 25a
Smithtown, NY 11787-1348

Mailing address

535 Elwood Rd
East Northport, NY 11731-4806
Phone (631) 368-0743

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20110614000154 NY Practitioner - Nurse Practitioner 6103003447 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
304441NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Oct 1, 2019 Accepting new patients

Locations

27005 76th Ave
North New Hyde Pk, NY 11040

101 Hospital Rd
Patchogue, NY 11772
Phone (631) 654-7100

300 Community Dr
Plandome, NY 11030

50 Route 25A
Smithtown, NY 11787
Phone (631) 465-6225

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212451200000",
    "number": "1407015654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 ELWOOD RD",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117314806",
            "telephone_number": "631-368-0743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 ROUTE 25A",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117871348",
            "telephone_number": "631-862-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONE",
        "first_name": "MAUREEN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "ANP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-03",
        "last_updated": "2008-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "304441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.