Anna Elizabeth Malloy, CPNP-PC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP022972 Issued in PA

Practice address

2240 Ridgewood Rd Ste 100
Wyomissing, PA 19610-1286

Phone

(610) 376-8691

Fax

(610) 376-8745

NPI assigned

Jun 15, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Berks Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Reading, PA
  • NPI 1649525569
  NPD
• Berks Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Reading, PA
  • NPI 1649938283
  NPD
• Berks Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Reading, PA
  • NPI 1770877581
  NPD (past)
• The Childrens Clininic of Wyomissing

  • Pediatrics Physician
  • Wyomissing, PA
  • NPI 1356341770
  NPD (past)

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

{
    "created_epoch": "1529020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1649764358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 RIDGEWOOD RD STE 100",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101286",
            "telephone_number": "610-376-8691",
            "fax_number": "610-376-8745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 RIDGEWOOD RD STE 100",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101286",
            "telephone_number": "610-376-8691",
            "fax_number": "610-376-8745"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 Main St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Pennsburg",
            "state": "PA",
            "postal_code": "180731631",
            "country_code": "US",
            "telephone_number": "267-923-8646",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7215 US 27",
            "address_purpose": "LOCATION",
            "city": "Sebring",
            "state": "FL",
            "postal_code": "33870",
            "country_code": "US",
            "telephone_number": "863-471-0235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLOY",
        "first_name": "ANNA",
        "middle_name": "ELIZABETH",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-15",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP9487280",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP022972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PCNB CERTIFICATION",
            "identifier": "20180497",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL DEPT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE",
            "identifier": "ARNP9487280",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1038679770001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE PA",
            "identifier": "SP022972",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edna Z Mahmood, M.D.
• Nora Maidansky, PSY.D.
• Kevin Maier II, M.S.
• Alicia Marie Makuta, M.S. CCC SLP
• Anna Maria Maldonado
• Barry C Malloy, MD
• Elisa Malloy
• Stephen A Maniaci, DDS
• Taylor Mannino, LPC
• Judy Ann Marburger, LPN

• Nurse Practitioner in Wyomissing, PA
• Providers in Wyomissing, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.