Individual provider Active NPI

Stephen Guy Mallette, D.O.

  • Dermatology Physician
  • Athens, AL
National Provider Identifier
1700849411
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
DO-841 Issued in AL
Practice address
707 US Highway 31 S
Suite F
Athens, AL 35611-3619
Phone
(256) 771-1995
Fax
(256) 771-1965
NPI assigned
Apr 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X DO-841 AL Primary

Addresses

Primary practice location

707 US Highway 31 S
Suite F
Athens, AL 35611-3619

Mailing address

707 US Highway 31 S
Suite F
Athens, AL 35611-3619
Phone (259) 771-1995

Other identifiers 1

IdentifierTypeStateIssuer
51522611OtherALBLUE CROSS BLUE SHIELD AL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20040821000094 AL Practitioner - Dermatology 0143294678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Nova Southeastern College of Osteo Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mallette DermatologyGroup PAC ID 7517931041, 2 clinicians

Practice addresses (Care Compare)

15248 Greenfield Dr
Athens, AL 35613-2897
Phone (256) 771-1995

Hospital & facility affiliations

  • Athens Limestone Hospital Hospital, Athens, AL, CCN 010079
  • Huntsville Hospital Hospital, Huntsville, AL, CCN 010039

Merit-based Incentive Payment System (MIPS)

Final score
91.67 of 100Reported as individual
Quality
83.33
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions2167
Removal or shaving of skin growth63
Skin biopsy65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO-841ALMDDermatology Physician

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204502400000",
    "number": "1700849411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 US HIGHWAY 31 S",
            "address_2": "SUITE F",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356113619",
            "telephone_number": "259-771-1995",
            "fax_number": "256-771-1965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 US HIGHWAY 31 S",
            "address_2": "SUITE F",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356113619",
            "telephone_number": "256-771-1995",
            "fax_number": "256-771-1965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLETTE",
        "first_name": "STEPHEN",
        "middle_name": "GUY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2008-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AL",
            "license": "DO-841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD AL",
            "identifier": "51522611",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, AL

Sources for this page

Verify at the official NPI Registry.