Michael Malizia, RN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

28067 Issued in SC

Practice address

3227 Walter Dr Ste 1B
Johns Island, SC 29455-8171

Phone

(843) 872-5454

Fax

(843) 872-5501

NPI assigned

May 25, 2018

Sex

Male

Sole proprietor

Yes

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 SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Uderitz Family Psychiatry LLCGroup PAC ID 8325313851, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

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.

• Uderitz Family Psychiatry, LLC

  dba Angel Oak Counseling

  • Psychiatry Physician
  • Johns Island, SC
  • NPI 1477077329
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1527206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698451200000",
    "number": "1508357534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 THORNHILL DR",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858386",
            "telephone_number": "845-489-4983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3227 WALTER DR STE 1B",
            "city": "JOHNS ISLAND",
            "state": "SC",
            "postal_code": "294558171",
            "telephone_number": "843-872-5454",
            "fax_number": "843-872-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALIZIA",
        "first_name": "MICHAEL",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-25",
        "last_updated": "2023-10-28",
        "certification_date": "2023-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "28067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lowcountry Dental Associates
• Lowcountry Medical Associates (John's Island Family Medicine)
• Jeanne Bennett Lumpkin, MD
• Cailin Lutz, PHARMD
• Brittany Work Mainord, LPC-A
• Cristina Malone, LISW-CP
• Bernard Mansheim, MD
• Derek Scott Maroun, O.D.
• C Gregory Martin, MD
• Grace Elizabeth Powell Martz, DPT

• Psychiatric/Mental Health Nurse Practitioner in Johns Island, SC
• Providers in Johns Island, SC by specialty
• Psychiatric/Mental Health Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.