Individual provider Active NPI

Thomas Joseph Malbrough, MD

  • Physical Medicine & Rehabilitation Physician
  • Festus, MO
National Provider Identifier
1609193937
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
2012037335 Issued in MO
Practice address
1390 US Highway 61 Ste N1500
Festus, MO 63028-4137
Phone
(636) 933-8940
Fax
(636) 933-8941
NPI assigned
Apr 26, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 2012037335 MO Primary

Addresses

Primary practice location

1390 US Highway 61 Ste N1500
Festus, MO 63028-4137

Mailing address

1390 US Highway 61 Ste N1500
Festus, MO 63028-4137
Phone (636) 933-8940

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160803000446 MO Practitioner - Physical Medicine and Rehabilitation 5496049173 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Louisiana State University School of Medicine in New Orleans, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Pain Management LLCGroup PAC ID 5890922066, 24 clinicians

Practice addresses (Care Compare)

15945 Clayton Rd
Suite 220
Ballwin, MO 63011-2491
Phone (636) 239-8097

851 E 5TH St
Washington, MO 63090-3129

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Pain Management, LLC CurrentSince Dec 15, 2022 Accepting new patients
Mercy Clinic Surgical Specialists, LLC CurrentSince Feb 2, 2023 Accepting new patients

Locations

15945 Clayton Rd
Ste 210
Ballwin, MO 63011
Phone (636) 893-1356

15945 Clayton Rd
Ste 220CLAY
Ballwin, MO 63011
Phone (636) 239-8097

1390 US Highway 61
Ste N1500
Crystal Cty, MO 63028
Phone (636) 933-5055

621 S New Ballas Rd
Ste 3005B
Saint Louis, MO 63141
Phone (314) 251-7070

701 S New Ballas Rd
Ste 320
Saint Louis, MO 63141
Phone (314) 251-6343

851 E 5th St
Ste 226
Washington, MO 63090
Phone (636) 239-8097

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1609193937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 US HIGHWAY 61 STE N1500",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284137",
            "telephone_number": "636-933-8940",
            "fax_number": "636-933-8941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 US HIGHWAY 61 STE N1500",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284137",
            "telephone_number": "636-933-8940",
            "fax_number": "636-933-8941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALBROUGH",
        "first_name": "THOMAS",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-26",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MO",
            "license": "2012037335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Festus, MO

Sources for this page

Verify at the official NPI Registry.