NPIMap

Individual provider Active NPI

Tennison Malcolm

  • Pain Medicine (Anesthesiology) Physician
  • Dover, NH
National Provider Identifier
1447670468
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
23944 Issued in NH
Practice address
789 Central Ave
Dover, NH 03820-2526
Phone
(603) 609-6819
NPI assigned
Apr 17, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 283138 MA
Pain Medicine (Anesthesiology) Physician 207LP2900X 23944 NH Primary

Addresses

Primary practice location

789 Central Ave
Dover, NH 03820-2526

Mailing address

PO Box 412503
Boston, MA 02241-2503
Phone (617) 726-3884

Other practice location 1

75 Francis St Dept Of
Boston, MA 02115-6110
Phone (617) 732-5500

Other names 1

  • Dr. Tennison Malcolm Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, NH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210927002217 IL Practitioner - AnesthesiologyPractitioner - Pain Management 7810316601 Reassigns benefits to 2 organizations
I20230817001123 NH Practitioner - Pain ManagementPractitioner - Anesthesiology 7810316601 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Associated Anesthesiologists SCGroup PAC ID 6305744129, 150 clinicians

Practice addresses (Care Compare)

6742 N Frostwood Pkwy
Peoria, IL 61615-2402
Phone (309) 692-5393

789 Central Ave
Dover, NH 03820-2526
Phone (603) 740-2421

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wentworth Douglass Physician Corporation CurrentSince Sep 1, 2023 Accepting new patients
The University of Chicago Medical Center CurrentSince Aug 13, 2021 Accepting new patients
Wentworth Douglass Physician Corporation Pain Medicine CurrentSince Sep 1, 2023 Accepting new patients
Associated Anesthesiologists, S.C. Anesthesiology CurrentSince Jul 31, 2023 Accepting new patients
Associated Anesthesiologists, SC Anesthesiology CurrentSince Jul 31, 2023 Accepting new patients
Wentworth Douglass Hospital Current Accepting new patients
The University of Chicago Medical Center CurrentSince Aug 13, 2021 Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

530neglen Oak Ave
Peoria, IL 61637
Phone (309) 692-5393

6742 N Frostwood Pkwy
Peoria, IL 61615
Phone (309) 692-5393

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

67 Corporate Dr
Ste 200
Portsmouth, NH 03801
Phone (603) 431-5529

158 Route 108
Ste 100
Somersworth, NH 03878
Phone (603) 609-6189

Interoperability endpoints

  • Direct secure messaging: tmalcolm218919@uchospital.direct-ci.com
  • Direct secure messaging: malcolm.tennison.wdh@direct.partners.masshiway.net

Organizations & group practices 8

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 2

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": "1397692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1447670468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412503",
            "telephone_number": "617-726-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 CENTRAL AVE",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202526",
            "telephone_number": "603-609-6819"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Francis St Dept Of",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021156110",
            "country_code": "US",
            "telephone_number": "617-732-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALCOLM",
        "first_name": "TENNISON",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-17",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "283138",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NH",
            "license": "23944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TENNISON",
            "last_name": "MALCOLM",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Dover, NH

Sources for this page

Verify at the official NPI Registry.