NPIMap

Organization Active NPI

Stephen M Maloff MD PA

  • Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
  • Pocatello, ID
National Provider Identifier
1417155284
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery Within the Head and Neck (Plastic Surgery) PhysicianTaxonomy code 2082S0099X
License
M3508 Issued in ID
Legal business name
STEPHEN M MALOFF MD PA
Practice address
1950 E Clark Street
Suite a
Pocatello, ID 83205
Phone
(208) 232-5550
Fax
(208) 232-5553
NPI assigned
Jul 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Stephen M Maloff, MDNPI 1316059280
Title
Physician
Phone
(208) 232-5550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Within the Head and Neck (Plastic Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2082S0099X M3508 ID Primary

Addresses

Primary practice location

1950 E Clark Street
Suite a
Pocatello, ID 83205

Mailing address

PO Box 4948
1950 E Clark Street Suite a
Pocatello, ID 83205
Phone (208) 232-5550

Other identifiers 1

IdentifierTypeStateIssuer
D03833100MedicaidID

National Provider Directory

National Provider Directory

Locations

1950 E Clark St
Ste A
Pocatello, ID 83201
Phone (208) 232-5550

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417155284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4948",
            "address_2": "1950 E CLARK STREET SUITE A",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83205",
            "telephone_number": "208-232-5550",
            "fax_number": "208-232-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 E CLARK STREET",
            "address_2": "SUITE A",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83205",
            "telephone_number": "208-232-5550",
            "fax_number": "208-232-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN M MALOFF MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MALOFF",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "208-232-5550",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2082S0099X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "ID",
            "license": "M3508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D03833100",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.