Individual provider Active NPI

Marci Malone, M.D.

  • Anesthesiology Physician
  • Latham, NY
National Provider Identifier
1487638029
Registry record updated Mar 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
203323 Issued in NY
Practice address
5 Johnson Rd
Latham, NY 12110-3096
Phone
(518) 782-1181
Fax
(518) 782-9171
NPI assigned
Dec 6, 2005
Last updated
Mar 20, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 203323 NY Primary

Addresses

Primary practice location

5 Johnson Rd
Latham, NY 12110-3096

Mailing address

PO Box 1849
Lewiston, ME 04241-1849
Phone (207) 784-2554

Other identifiers 1

IdentifierTypeStateIssuer
02090664MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040428001609 NY Practitioner - Anesthesiology 8921095183 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Ohio State University College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sedation Vacation Perioperative Medicine PLLCGroup PAC ID 1759658594, 86 clinicians
Gold Coast Medical PCGroup PAC ID 8820247703, 4 clinicians

Practice addresses (Care Compare)

1396 Myrtle Ave
Brooklyn, NY 11237-4513
Phone (718) 222-5999

237 Jericho Tpke
Syosset, NY 11791-4513
Phone (516) 584-6400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
203323NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amsterdam Rec LLC CurrentSince Mar 7, 2020 Accepting new patients
JJM Medical Services, PC Anesthesiology CurrentSince Mar 31, 2011 Accepting new patients
West Side Gi, LLC CurrentSince Jul 21, 2022 Accepting new patients
Centurion Midtown Anesthesia PLLC Anesthesiology CurrentSince Sep 1, 2024 Accepting new patients
Sedation Vacation Perioperative Medicine PLLC CurrentSince Dec 29, 2024 Accepting new patients
Gold Coast Medical P C Anesthesiology CurrentSince Sep 15, 2012 Accepting new patients
Progressive Anesthesia PLLC Anesthesiology Past Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
Fpa Hospital Based Past Accepting new patients
T.Y. Kim, M.D., P.C. Past Accepting new patients
Vantage Anesthesia PC Anesthesiology Past Accepting new patients

Locations

1440 Main St
Waltham, MA 02451
Phone (781) 891-9300

108 Holland Circle Dr
Amsterdam, NY 12010
Phone (518) 842-3800

100 Holland Circle Dr
Amsterdam, NY 12010
Phone (518) 713-4484

3127 41st St
Astoria, NY 11103
Phone (212) 353-9443

1396 Myrtle Ave
Brooklyn, NY 11237
Phone (718) 878-4313

200 Broadway
Ste 3116
Brooklyn, NY 11211

35 Spencer St
Ste 200
Brooklyn, NY 11205

5 Johnson Rd
Latham, NY 12110
Phone (518) 767-0869

8745 Lake Street Rd
Le Roy, NY 14482
Phone (585) 267-7570

619 W 54th St
Fl 8
New York, NY 10019
Phone (212) 889-3142

10512 101st Ave
Ozone Park, NY 11416
Phone (718) 847-3600

237 Jericho Tpke
Syosset, NY 11791
Phone (516) 584-6400

Interoperability endpoints

  • Direct secure messaging: marci.malone.1@21260.direct.athenahealth.com

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395273600000",
    "number": "1487638029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1849",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042411849",
            "telephone_number": "207-784-2554",
            "fax_number": "207-777-5363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 JOHNSON RD",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121103096",
            "telephone_number": "518-782-1181",
            "fax_number": "518-782-9171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONE",
        "first_name": "MARCI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2014-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "203323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02090664",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

Verify at the official NPI Registry.