Kelly A Malloy, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG000087 Issued in PA

Practice address

1200 W Godfrey Ave
Philadelphia, PA 19141-3323

Phone

(215) 276-6000

NPI assigned

Aug 4, 2006

Last updated

Apr 5, 2012By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pennsylvania College of Optometry, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Drexel UniversityGroup PAC ID 5496664740, 80 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: kelly.malloy.p1@direct.salusuhealth.nextgenshare.com

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.

• Drexel University

  dba Drexel Psychology

  • Psychologist
  • Philadelphia, PA
  • NPI 1902900095
  Medicare reassignment Care Compare group NPD
• Drexel University

  dba The Eye Institute

  • Optometrist
  • Philadelphia, PA
  • NPI 1336160027
  Medicare reassignment NPD
• Drexel University

  dba Pennsylvania Ear Institute

  • Audiologist
  • Elkins Park, PA
  • NPI 1104822253
  NPD
• Drexel University

  dba Drexel ID Partnership Clinic

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1538279732
  NPD
• Salus University Hearing Vision Balance Clinic

  • Audiologist
  • Elkins Park, PA
  • NPI 1154785293

  Optometrist

  NPD
• Pennsylvania College of Optometry

  dba The Eye Institute

  • Optometrist
  • Philadelphia, PA
  • NPI 1134166572
  NPD (past)

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333584000000",
    "number": "1598773384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 E MAPLE AVE",
            "city": "BELLMAWR",
            "state": "NJ",
            "postal_code": "080311250",
            "telephone_number": "609-933-3832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W GODFREY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413323",
            "telephone_number": "215-276-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLOY",
        "first_name": "KELLY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2012-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "1547286",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Keith Mallow, M.D.
• Allison M Mallowe, MA, RD, LDN
• Christopher Thomas Malloy, CRNA
• Cordella Malloy, PH.D
• Jennifer Malloy, CRNP
• Margaret Ann Malloy, PA-C
• Melissa A. Malloy, CRNA
• Stephanie Angela Malloy
• Amulya Reddy Mallu, MD
• Giridhar Mallya, MD

• Optometrist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; 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.