Individual provider Active NPI

Marcio Henrique Malogolowkin, MD

  • Pediatric Hematology & Oncology Physician
  • Sacramento, CA
National Provider Identifier
1457451270
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
A49278 Issued in CA
Practice address
2516 Stockton Blvd
Sacramento, CA 95817-2208
Phone
(916) 734-2781
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hematology & Oncology Physician 2080P0207X 57273-20 WI
Pediatric Hematology & Oncology Physician 2080P0207X A49278 CA Primary

Addresses

Primary practice location

2516 Stockton Blvd
Sacramento, CA 95817-2208

Mailing address

2516 Stockton Blvd
Sacramento, CA 95817-2208
Phone (916) 734-2781

Other practice location 1

9000 W Wisconsin Ave
Childrens Hospital of Wisconsin
Milwaukee, WI 53226-4874
Phone (414) 955-4170

Other identifiers 2

IdentifierTypeStateIssuer
00A492780MedicaidCA
00A492780 G15OtherCACAL OPTIMA

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100111000484 CA Practitioner - Pediatric MedicinePractitioner - Hematology/Oncology 3375684590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Hematology/Oncology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone (916) 734-2011

2521 Stockton Blvd
Sacramento, CA 95817-2207
Phone (916) 724-5400

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
64.8
Promoting interoperability
100
Improvement activities
40
Cost
68.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49278CAMDDentist
A49278CAMDPediatric Hematology & Oncology Physician
57273-20WIMDPediatric Hematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the University of Ca CurrentSince Oct 26, 2009 Accepting new patients
Children's Hospital of Wisconsin, Inc. Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Childrens Hospital of Los Angeles Past Accepting new patients

Locations

2521 Stockton Blvd
Ste 3200
Sacramento, CA 95817
Phone (916) 734-3112

2521 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-1104

4501 X St
Sacramento, CA 95817
Phone (916) 734-5959

2279 45th St
Sacramento, CA 95817
Phone (916) 734-5959

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1457451270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2516 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172208",
            "telephone_number": "916-734-2781",
            "fax_number": "916-451-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2516 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172208",
            "telephone_number": "916-734-2781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9000 W Wisconsin Ave",
            "address_2": "CHILDRENS HOSPITAL OF WISCONSIN",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532264874",
            "country_code": "US",
            "telephone_number": "414-955-4170",
            "fax_number": "414-955-6543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALOGOLOWKIN",
        "first_name": "MARCIO",
        "middle_name": "HENRIQUE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "WI",
            "license": "57273-20",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "CA",
            "license": "A49278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A492780",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAL OPTIMA",
            "identifier": "00A492780 G15",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.