Individual provider Active NPI

Lisa Allison Malyak, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Wilson, NC
National Provider Identifier
1437787462
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
2026-04699 Issued in NC
Practice address
1803 Forest Hills Rd W
Wilson, NC 27893-3412
Phone
(252) 243-9629
Fax
(252) 243-7339
NPI assigned
Mar 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 0451323 KS
Student in an Organized Health Care Education/Training Program 390200000X
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 2026-04699 NC Primary

Addresses

Primary practice location

1803 Forest Hills Rd W
Wilson, NC 27893-3412

Mailing address

PO Box 5105
Belfast, ME 04915-5100
Phone (919) 220-5255

Other practice location 1

University of Colorado School of Medicine GME
13001 East 17th Place
Aurora, CO 80045-2581
Phone (303) 724-8472

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20201112001786 CO Order and Referring Only - Orthopedic SurgeryPractitioner - Orthopedic Surgery 0345650834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0451323KSMDSports Medicine (Orthopaedic Surgery) Physician

NPI Registry JSON

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1437787462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5105",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049155100",
            "telephone_number": "919-220-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 FOREST HILLS RD W",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278933412",
            "telephone_number": "252-243-9629",
            "fax_number": "252-243-7339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "University of Colorado School of Medicine GME",
            "address_2": "13001 East 17th Place",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800452581",
            "country_code": "US",
            "telephone_number": "303-724-8472",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALYAK",
        "first_name": "LISA",
        "middle_name": "ALLISON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-27",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "KS",
            "license": "0451323",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NC",
            "license": "2026-04699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilson, NC

Sources for this page

Verify at the official NPI Registry.