Individual provider Active NPI

John Patrick Malloy IV, DO

  • Orthopaedic Surgery Physician
  • Coconut Creek, FL
National Provider Identifier
1447450424
Registry record updated Nov 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
OS11281 Issued in FL
Practice address
4515 Wiles Rd Ste 201
Coconut Creek, FL 33073-3414
Phone
(954) 500-4554
Fax
(954) 400-0904
NPI assigned
Jul 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X OS014015 PA
Orthopaedic Surgery Physician 207X00000X OT011278 PA
Orthopaedic Surgery Physician 207X00000X H70338 MD
Orthopaedic Surgery Physician 207X00000X OS11281 FL Primary

Addresses

Primary practice location

4515 Wiles Rd Ste 201
Coconut Creek, FL 33073-3414

Mailing address

2225 SW 14TH PL
Boca Raton, FL 33486-8558
Phone (954) 500-4554

Other practice location 1

7805 NW Beacon Square Blvd Ste 103
Boca Raton, FL 33487-1396
Phone (954) 500-4554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110920000559 FL Practitioner - Orthopedic Surgery 5193918514 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Philadelphia College of Osteopathic Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4515 Wiles Rd
Suite 201
Coconut Creek, FL 33073-3414
Phone (954) 500-4554

7805 NW Beacon Square Blvd
Suite 103
Boca Raton, FL 33487-1396
Phone (954) 500-4554

Hospital & facility affiliations

  • USA Home Health Services Home health agency, Plantation, FL, CCN 107397
  • Community Home Health Services Home health agency, Fort Lauderdale, FL, CCN 107103
  • USA Home Health Services, Inc. Home health agency, Delray Beach, FL, CCN 107785
  • HCA Florida Northwest Hospital Hospital, Margate, FL, CCN 100189
  • Broward Health North Hospital, Deerfield Beach, FL, CCN 100086
  • Holy Cross Hospital Hospital, Ft Lauderdale, FL, CCN 100073
  • Boca Raton Regional Hospital Hospital, Boca Raton, FL, CCN 100168

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement1-10
Spinal fusion64
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Laminectomy or laminotomy (partial removal of spine bones)43
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H70338MDMDOrthopaedic Surgery Physician
OS014015PAMDOrthopaedic Surgery Physician
OT011278PAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Florida Spine and Orthopedics, LLC Orthopaedic Surgery CurrentSince Sep 24, 2019 Accepting new patients
Alexander Medical Group LLC Orthopaedic Surgery CurrentSince Sep 1, 2011 Accepting new patients

Locations

7805 NW Beacon Square Blvd
Ste 103
Boca Raton, FL 33487
Phone (561) 620-0174

4515 Wiles Rd
Ste 201
Coconut Creek, FL 33073
Phone (954) 943-1133

12416 66th St
Ste A
Largo, FL 33773
Phone 7275474700112

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 2

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.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637971200000",
    "number": "1447450424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 SW 14TH PL",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334868558",
            "telephone_number": "954-500-4554",
            "fax_number": "954-400-0904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 WILES RD STE 201",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330733414",
            "telephone_number": "954-500-4554",
            "fax_number": "954-400-0904"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7805 NW Beacon Square Blvd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334871396",
            "country_code": "US",
            "telephone_number": "954-500-4554",
            "fax_number": "954-400-0904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLOY",
        "first_name": "JOHN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-19",
        "last_updated": "2021-11-27",
        "certification_date": "2021-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "OS014015",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "OT011278",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MD",
            "license": "H70338",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "OS11281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coconut Creek, FL

Sources for this page

Verify at the official NPI Registry.