Bryan Malcolm, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

59403 Issued in CA

Practice address

101 Bodin Cir
Travis Afb, CA 94535-1809

Phone

(707) 423-3825

NPI assigned

Jan 2, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

99.12 of 100Reported as group

Quality

94.64

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

88.38 of 100Reported as group

Quality

77.6

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Emergency Medicine Physician Partners of El Dorado County, Inc

  • Emergency Medicine Physician
  • Placerville, CA
  • NPI 1619278660
  Medicare reassignment
• Woodland Emergency Physicians Medical Group Inc

  • Emergency Medicine Physician
  • Woodland, CA
  • NPI 1881868164
  Medicare reassignment

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

{
    "created_epoch": "1357084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1437495959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-3825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-3825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALCOLM",
        "first_name": "BRYAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-02",
        "last_updated": "2022-02-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "59403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian David Lunt, DDS
• Keegan Michael Lyons, MD MPH
• Nathan Louis Maassel, MD
• Jennifer Magnuson
• Yurong Mai, MD
• Alexander Maldonado, D.D.S
• Sareena Malhi, MD
• Patrick Ryan Maloney, MD
• Unna Camille Coronel Mangune, DPT
• Mary Grace Alusen Manog

• Medical Physician Assistant in Travis Afb, CA
• Providers in Travis Afb, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; 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.