Maria D Mallory, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

47718 Issued in MN

Practice address

1200 6TH Ave N
Saint Cloud, MN 56303-2735

Phone

(320) 252-5131

Fax

(320) 240-2118

NPI assigned

Oct 25, 2005

Last updated

Nov 28, 2011By 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 8

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

General Surgery

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Cloud HospitalGroup PAC ID 4880594779, 215 clinicians

Centracare ClinicGroup PAC ID 2466363395, 800 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centracare - St. Cloud Hospital Hospital, Saint Cloud, MN, CCN 240036

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmallory1422@direct.centracare.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.

• Centracare Clinic

  dba CentraCare - River Campus Clinic

  • Multi-Specialty Clinic/Center
  • Saint Cloud, MN
  • NPI 1043212665
  Medicare reassignment Care Compare group NPD
• St. Cloud Hospital

  • General Acute Care Hospital
  • Saint Cloud, MN
  • NPI 1043269798
  Medicare reassignment Care Compare group NPD
• Centracare Health System - Long Prairie

  • Critical Access Hospital
  • Long Prairie, MN
  • NPI 1164471678
  Medicare reassignment NPD
• Centracare Health System - Melrose

  dba CentraCare Health - Melrose Hospital

  • Critical Access Hospital
  • Melrose, MN
  • NPI 1720045073
  Medicare reassignment NPD
• Centracare Health System - Sauk Centre

  dba CentraCare Health - Sauk Centre Clinic

  • Rural Health Clinic/Center
  • Sauk Centre, MN
  • NPI 1578813762
  Medicare reassignment NPD
• Centracare Health System - Sauk Centre

  • Critical Access Hospital
  • Sauk Centre, MN
  • NPI 1740553932
  Medicare reassignment NPD
• Centracare Health System-NR LLC

  dba CentraCare Health - Monticello Hospital

  • Critical Access Hospital
  • Monticello, MN
  • NPI 1275872772
  Medicare reassignment NPD
• Centracare Health System-NR LLC

  dba CentraCare - Monticello Specialty Clinic

  • Multi-Specialty Clinic/Center
  • Monticello, MN
  • NPI 1558600874
  Medicare reassignment NPD
• Centracare Health-Paynesville LLC

  dba CentraCare Health - Paynesville Hospital

  • Critical Access Hospital
  • Paynesville, MN
  • NPI 1205269941
  Medicare reassignment NPD
• Centracare Health-Paynesville LLC

  dba CentraCare Health - Paynesville Clinic

  • Rural Health Clinic/Center
  • Paynesville, MN
  • NPI 1629402516
  Medicare reassignment NPD
• Centracare Clinic

  dba CentraCare Occupations Health

  • Occupational Medicine Clinic/Center
  • Saint Cloud, MN
  • NPI 1366192759
  NPD
• Centracare Health System - Long Prairie

  • Rural Health Clinic/Center
  • Long Prairie, MN
  • NPI 1497986582
  NPD

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

• St Cloud Hospital

  dba CentraCare St Cloud Hospital Adolescent Addiction Services

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Saint Cloud, MN
  • NPI 1811150618
  Care Compare affiliation
• St. Cloud Hospital

  • General Acute Care Hospital
  • Saint Cloud, MN
  • NPI 1043269798
  Care Compare affiliation
• St. Cloud Hospital

  dba St Cloud Hospital Behavioral Health - Sartell

  • Mental Health Counselor
  • Sartell, MN
  • NPI 1083161814

  Hospital

  Care Compare affiliation
• St. Cloud Hospital

  dba Recovery Plus Adult Program-St Cloud Hospital

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Saint Cloud, MN
  • NPI 1467615294
  Care Compare affiliation
• St. Cloud Hospital

  dba CentraCare Wound Center

  • General Acute Care Hospital
  • Saint Cloud, MN
  • NPI 1841502929
  Care Compare affiliation
• St. Cloud Hospital

  dba Extended Contract Inpt Psych Services

  • Psychiatric Hospital Unit
  • Saint Cloud, MN
  • NPI 1932419058
  Care Compare affiliation

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322438400000",
    "number": "1689664344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 6TH AVE N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032735",
            "telephone_number": "320-252-5131",
            "fax_number": "320-240-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 6TH AVE N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032735",
            "telephone_number": "320-252-5131",
            "fax_number": "320-240-2118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLORY",
        "first_name": "MARIA",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-25",
        "last_updated": "2011-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "47718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U CARE",
            "identifier": "132828",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "346G4MA",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ GROUP AMERICAS PPO",
            "identifier": "2357287",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1043623",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE",
            "identifier": "754479100",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP52031",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA HEALTH PLANS",
            "identifier": "1701414",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "6D053CE",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fowsiya Makaran
• Zakeria Mohamed Makaran
• Sara Makarrall
• Theresa Makoons-Solarz, MS LP
• Perry Robert Malcolm, MD
• Andrew O'Connor Maloney, MD
• Katie Malotky, PT
• Amber Manders
• Kristen Manderschied, NP
• Madeline Mangin, MD

• Surgery Physician in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Surgery Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; 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.