Jennifer Mallas, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

0756 Issued in WI

Practice address

1350 S Sunny Slope Rd
Brookfield, WI 53005-7060

Phone

(414) 805-9600

Fax

(414) 805-9645

NPI assigned

May 14, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Froedtert Andthe Medical College of Wisconsin Community Physicians IncGroup PAC ID 3678760063, 1,265 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Internal Medicine Physician
  • Menomonee Falls, WI
  • NPI 1568787448
  Medicare reassignment Care Compare group
• Ascension Medical Group-Southeast Wisconsin Inc

  • Internal Medicine Physician
  • Glendale, WI
  • NPI 1609881077
  Medicare reassignment NPD
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086
  NPD

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431561600000",
    "number": "1497133151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 S SUNNY SLOPE RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530057060",
            "telephone_number": "414-805-9600",
            "fax_number": "414-805-9645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 S SUNNY SLOPE RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530057060",
            "telephone_number": "414-805-9600",
            "fax_number": "414-805-9645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLAS",
        "first_name": "JENNIFER",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-14",
        "last_updated": "2015-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "0756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin L Mainville, MS, LPC
• Jacquelyn Marjorie Majerowski, M.D.
• Andrew Makela
• Laurel L Makovsky, MS CCC SLP
• Deborah Ann Makowski, SPEECH PATHOLOGIST
• Mohammad S Mallick, MD
• Keri Mallon
• Mary Ellen Malloy, OT
• Angela Marie Malm, OTR
• Maria Manby, M.S. SLP/CCC

• Occupational Therapist in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.