NPIMap

Individual provider Active NPI

Paul Malick, D.O.

  • Family Medicine Physician
  • Southgate, MI
National Provider Identifier
1659585206
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101016048 Issued in MI
Practice address
15777 Northline Rd Ste 202
Southgate, MI 48195-2354
Phone
(734) 246-8100
Fax
(734) 246-8621
NPI assigned
May 10, 2007
Last updated
Jul 29, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101016048 MI Primary

Addresses

Primary practice location

15777 Northline Rd Ste 202
Southgate, MI 48195-2354

Mailing address

26901 Beaumont Blvd # 3D
Southfield, MI 48033-3849
Phone (947) 522-1952

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pmalick118041@direct.beaumont.edu

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090225000183 MI Practitioner - Family Practice 4981760071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City University of Physicians and Surgeons, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mecosta County Medical CenterGroup PAC ID 1951215540, shared by 6 NPIs, 53 clinicians
Oakwood Ambulatory LLCGroup PAC ID 1850282914, 271 clinicians

Practice addresses (Care Compare)

14755 215TH Ave
Big Rapids, MI 49307-9224
Phone (231) 796-3200

15777 Northline Rd
Southgate, MI 48195-2354
Phone (734) 246-8100

201 3Rd St
Suite 200
Belleville, MI 48111-2605
Phone (734) 697-9065

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Oakwood Ambulatory LLC Family Medicine CurrentSince Feb 1, 2009 Accepting new patients
Oakwood Ambulatory, LLC CurrentSince Feb 1, 2009 Accepting new patients

Locations

201 3rd St
Ste 200
Belleville, MI 48111
Phone (734) 697-9065

26901 Beaumont Blvd
#3D
Southfield, MI 48033

15777 Northline Rd
Southgate, MI 48195
Phone (734) 246-8100

15777 Northline Rd
Ste 202
Southgate, MI 48195
Phone (734) 246-8100

Interoperability endpoints

  • Direct secure messaging: pmalick118041@direct.beaumont.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1659585206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD # 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1952",
            "fax_number": "947-522-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15777 NORTHLINE RD STE 202",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952354",
            "telephone_number": "734-246-8100",
            "fax_number": "734-246-8621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALICK",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101016048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pmalick118041@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "15777 Northline Rd Ste 202",
            "city": "Southgate",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481952354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Southgate, MI

Sources for this page

Verify at the official NPI Registry.