John Kenneth Mallen, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

10052 Issued in NH

Practice address

32 Stiles Rd
Ste 204
Salem, NH 03079

Phone

(603) 894-9898

Fax

(603) 894-6270

NPI assigned

Jan 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in NH

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

Specialty

Plastic and Reconstructive Surgery

Education

Tufts University School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holy Family Hospital Hospital, Methuen, MA, CCN 220080
• Merrimack Health Lawrence Hospital Hospital, Lawrence, MA, CCN 220010

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Jeffrey Abboud MD Plastic Surgery PLLC

  • Plastic Surgery Physician
  • Salem, NH
  • NPI 1699666859
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lawrence General Hospital

  • General Acute Care Hospital
  • Lawrence, MA
  • NPI 1750381281
  Care Compare affiliation
• LG Newcorp Inc

  • General Acute Care Hospital
  • Methuen, MA
  • NPI 1265267991
  Care Compare affiliation

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346716800000",
    "number": "1427037951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 STILES RD",
            "address_2": "STE 204",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "03079",
            "telephone_number": "603-894-9898",
            "fax_number": "603-894-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 STILES RD",
            "address_2": "STE 204",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "03079",
            "telephone_number": "603-894-9898",
            "fax_number": "603-894-6270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLEN",
        "first_name": "JOHN",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2012-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NH",
            "license": "10052",
            "primary": true
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MA",
            "license": "154434",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "0103459Y0NH01",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD",
            "identifier": "21296",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "29841",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "07571390",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "154434",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "JIF258",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Madden
• Donna Magurno
• Hala Mahmod, DMD
• Cynthia Mailloux
• Sue Maker
• Olivia Cassidy Malloch, CADC
• Caroline Mandeville, OD
• Ryan Manning, OT
• Scott Manzolillo
• Meray Georgina Marawi, PT, DPT

• Plastic Surgery Physician in Salem, NH
• Providers in Salem, NH by specialty
• Plastic Surgery Physician in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.