Individual provider Active NPI

Garrett Malave

  • Student in an Organized Health Care Education/Training Program
  • Mesa, AZ
National Provider Identifier
1508776618
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
4510 E Banner Gateway Dr Apt 3031
Mesa, AZ 85206-4758
Phone
(631) 276-0929
NPI assigned
Sep 10, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

4510 E Banner Gateway Dr Apt 3031
Mesa, AZ 85206-4758

Mailing address

4510 E Banner Gateway Dr Apt 3031
Mesa, AZ 85206-4758
Phone (631) 276-0929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1508776618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4510 E BANNER GATEWAY DR APT 3031",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064758",
            "telephone_number": "631-276-0929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 E BANNER GATEWAY DR APT 3031",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064758",
            "telephone_number": "631-276-0929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALAVE",
        "first_name": "GARRETT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-09-10",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.