Individual provider Active NPI

Emily Ann Malo

  • Psychiatric/Mental Health Nurse Practitioner
  • Springfield, MA
National Provider Identifier
1669034773
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2285355 Issued in MA
Practice address
417 Liberty St
Springfield, MA 01104-3736
Phone
(413) 747-0705
NPI assigned
Jun 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2019043330 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2285355 MA Primary

Addresses

Primary practice location

417 Liberty St
Springfield, MA 01104-3736

Mailing address

457 Centre St Apt C
Newton, MA 02458-2078
Phone (315) 720-5385

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20191121000384 MA Practitioner - Nurse Practitioner 0244662773 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2019043330MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Network, Inc CurrentSince Sep 29, 2019 Accepting new patients
Behavioral Health Network Inc CurrentSince Sep 29, 2019 Accepting new patients
Handel Behavioral Health Services Inc Past Accepting new patients

Locations

40 Bobala Rd
Holyoke, MA 01040
Phone (413) 536-5473

110 Maple St
Springfield, MA 01105
Phone (413) 846-4300

417 Liberty St
Springfield, MA 01104
Phone (413) 733-6661

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1561680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1669034773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "457 CENTRE ST APT C",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024582078",
            "telephone_number": "315-720-5385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 LIBERTY ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011043736",
            "telephone_number": "413-747-0705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALO",
        "first_name": "EMILY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-28",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "2019043330",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2285355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.