Jose Manuel Malagon Jr.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

149020200 Issued in IL

Practice address

1784 Whirlaway CT
Glendale Heights, IL 60139-1300

Phone

(219) 629-4416

NPI assigned

Oct 21, 2018

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 IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blue Moon Senior Counseling of Illinois LLCGroup PAC ID 7012172893, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Blue Moon Senior Counseling of Illinois LLC

  • Clinical Social Worker
  • Plainfield, IL
  • NPI 1841562931
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1540080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1437625183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1784 WHIRLAWAY CT",
            "city": "GLENDALE HEIGHTS",
            "state": "IL",
            "postal_code": "601391300",
            "telephone_number": "219-629-4416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1784 WHIRLAWAY CT",
            "city": "GLENDALE HEIGHTS",
            "state": "IL",
            "postal_code": "601391300",
            "telephone_number": "219-629-4416"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 E Galena Blvd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "IL",
            "postal_code": "605053338",
            "country_code": "US",
            "telephone_number": "855-241-7160",
            "fax_number": "954-324-8354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALAGON",
        "first_name": "JOSE",
        "middle_name": "MANUEL",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-21",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "149020200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis Long, DHSC, CCP
• Luis Granados DDS PC
• Kaitlin Jeannette Mach, DMD
• Sumitha Mahkri
• Dennis Edward Mahoney, R.PH., MPS
• Subbashini Marimuthu, D.M.D
• Max Health Network
• Jonathan McDowell, RBT
• Kevin J McGarry, DC
• Mark McNally, DC

• Mental Health Counselor in Glendale Heights, IL
• Providers in Glendale Heights, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; 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.