NPIMap

Individual provider Active NPI

Justin Alan Malone, M.D.

  • Neurology Physician
  • Osage Beach, MO
National Provider Identifier
1689895534
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
2006001558 Issued in MO
Practice address
54 Hospital Drive
Osage Beach, MO 65065
Phone
(573) 302-2714
Fax
(573) 302-2713
NPI assigned
May 1, 2007
Last updated
Feb 13, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 2006001558 MO
Neurology Physician 2084N0400X 2006001558 MO Primary
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 2006001558 MO

Addresses

Primary practice location

54 Hospital Drive
Osage Beach, MO 65065

Mailing address

54 Hospital Drive
Osage Beach, MO 65065
Phone (573) 302-2714

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20070822001247 MO Practitioner - NeurologyPractitioner - Neuropsychiatry 6406948439 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Neuropsychiatry
Education
Creighton University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Regional Health SystemGroup PAC ID 9133026776, 132 clinicians

Practice addresses (Care Compare)

54 Hospital Dr
Osage Beach, MO 65065-3050
Phone (573) 348-8045

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2006001558MOMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Regional Health System CurrentSince Apr 1, 2025 Accepting new patients
Jefferson City Medical Group, P.C. Current Accepting new patients
Jefferson City Medical Group, P.C. CurrentSince Jul 1, 2018 Accepting new patients
Lake Regional Health System CurrentSince Apr 1, 2025 Accepting new patients
Lake Regional Medical Management, Inc. CurrentSince May 10, 2018 Accepting new patients
Jefferson City Medical Group, P.C. CurrentSince Jul 1, 2018 Accepting new patients
Jefferson City Medical Group, P.C. Current Accepting new patients
Curators of the University of Missouri Past Accepting new patients
Quantum Pediatric Neurology LLC PastSince May 18, 2025 Accepting new patients
Neurology Inc PC Specialist PastSince Dec 31, 1991 Accepting new patients
Audrain Health Care, Inc Past Accepting new patients
Lake Regional Health System Past Accepting new patients

Locations

525 N Keene St
Ste 301
Columbia, MO 65201
Phone (573) 239-8404

1241 W Stadium Blvd
Jefferson Cty, MO 65109
Phone (573) 556-5771

1241 W Stadium Blvd
#L400B
Jefferson Cty, MO 65109
Phone (573) 556-7724

620 E Monroe St
Mexico, MO 65265
Phone (573) 582-5000

54 Hospital Dr
Osage Beach, MO 65065
Phone (573) 280-2772

40 Sunset Ridge Rd
Ste 120
New Paltz, NY 12561

Interoperability endpoints

  • Direct secure messaging: justinmalone@mhccaremail.com

Organizations & group practices 12

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": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1689895534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 HOSPITAL DRIVE",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "65065",
            "telephone_number": "573-302-2714",
            "fax_number": "573-302-2713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 HOSPITAL DRIVE",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "65065",
            "telephone_number": "573-302-2714",
            "fax_number": "573-302-2713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONE",
        "first_name": "JUSTIN",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2025-02-13",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MO",
            "license": "2006001558",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "2006001558",
            "primary": true
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "MO",
            "license": "2006001558",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.1",
            "affiliationName": "Bluemark LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "40 Sunset Ridge Rd Ste 120",
            "city": "New Paltz",
            "state": "NY",
            "country_code": "US",
            "postal_code": "125611039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Osage Beach, MO

Sources for this page

Verify at the official NPI Registry.