Organization Active NPI

John G Malouf DO PA

  • Ophthalmology Physician
  • Corpus Christi, TX
National Provider Identifier
1558447300
Registry record updated Oct 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
L3387 Issued in TX
Legal business name
JOHN G MALOUF DO PA
Practice address
5022 Holly Rd
Suite 105
Corpus Christi, TX 78411-4761
Phone
(361) 985-2015
Fax
(361) 985-2016
NPI assigned
Oct 27, 2006
Last updated
Oct 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2008

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

Authorized official

Name
Mrs. Julie Ann Malouf
Title
Manager Billing
Phone
(361) 985-2015

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X L3387 TX Primary

Addresses

Primary practice location

5022 Holly Rd
Suite 105
Corpus Christi, TX 78411-4761

Mailing address

5022 Holly Rd
Suite 105
Corpus Christi, TX 78411-4761
Phone (361) 985-2015

Other identifiers 2

IdentifierTypeStateIssuer
152280703MedicaidTX
00047ZOtherTXMEDICARE GROUP ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050628001017 TX Part B Supplier - Clinic/Group Practice 0941246151 Receives reassigned benefits from 1 practitioner
Practice locations: Corpus Christi, TX

National Provider Directory

National Provider Directory

Locations

501 S Commercial St
Aransas Pass, TX 78336

5022 Holly Rd
Ste 105
Corpus Christi, TX 78411
Phone (361) 985-2015

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224720000000",
    "number": "1558447300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5022 HOLLY RD",
            "address_2": "SUITE 105",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784114761",
            "telephone_number": "361-985-2015",
            "fax_number": "361-985-2016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5022 HOLLY RD",
            "address_2": "SUITE 105",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784114761",
            "telephone_number": "361-985-2015",
            "fax_number": "361-985-2016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN G MALOUF DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2008-10-23",
        "status": "A",
        "authorized_official_last_name": "MALOUF",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "MANAGER BILLING",
        "authorized_official_telephone_number": "361-985-2015",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "L3387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152280703",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE  GROUP ID",
            "identifier": "00047Z",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.