Individual provider Active NPI

Mary Lorraine Malick

  • Family Nurse Practitioner
  • Valparaiso, IN
National Provider Identifier
1578600441
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
70000085A Issued in IN
Practice address
601 Wall St
Valparaiso, IN 46383-2512
Phone
(219) 531-3500
NPI assigned
Jan 31, 2007
Last updated
Apr 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.010129 IL
Family Nurse Practitioner 363LF0000X 70000085A IN Primary

Addresses

Primary practice location

601 Wall St
Valparaiso, IN 46383-2512

Mailing address

601 Wall St.
Valparaiso, IN 46383

Other names 1

  • Mary Lorraine Malick Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmalick@porterstarke.direct.smartcarenet.com Direct

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20100318000627 IN Practitioner - Nurse Practitioner 6507991312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Porter-Starke Services IncGroup PAC ID 1951293554, 44 clinicians

Practice addresses (Care Compare)

601 Wall St
Valparaiso, IN 46383-2512
Phone (574) 772-4040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.010129ILMDFamily Nurse Practitioner
70000085AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Porter-Starke Services Inc. CurrentSince May 3, 2017 Accepting new patients
Porter-Starke Services Inc. CurrentSince May 3, 2017 Accepting new patients
Porter-Starke Services Inc. Current Accepting new patients

Locations

704 S State Road 2
Hebron, IN 46341
Phone (219) 806-3011

1001 S Edgewood Dr
Ste 1
Knox, IN 46534
Phone (574) 772-4040

3176 Lancer St
Portage, IN 46368
Phone (219) 762-7318

601 Wall St
Valparaiso, IN 46383
Phone (219) 806-3011

701 Wall St
Valparaiso, IN 46383
Phone (219) 299-8419

Organizations & group practices 3

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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743724800000",
    "number": "1578600441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 WALL ST.",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "46383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 WALL ST",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832512",
            "telephone_number": "219-531-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALICK",
        "first_name": "MARY",
        "middle_name": "LORRAINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.010129",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "70000085A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmalick@porterstarke.direct.smartcarenet.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "601 Wall St",
            "city": "Valparaiso",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463832512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "MALICK",
            "middle_name": "LORRAINE",
            "credential": "RN, CNS, FNP-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Valparaiso, IN

Sources for this page

Verify at the official NPI Registry.