NPIMap

Individual provider Active NPI

Mary Grace Magalong, MD

  • Pulmonary Disease Physician
  • Dothan, AL
National Provider Identifier
1710080338
Registry record updated Sep 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
32733 Issued in AL
Practice address
4300 W. Main Street
Suite 102
Dothan, AL 36305-1051
Phone
(334) 793-9564
Fax
(334) 671-8907
NPI assigned
Sep 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X A72152 CA
Pulmonary Disease Physician 207RP1001X 32733 AL Primary

Addresses

Primary practice location

4300 W. Main Street
Suite 102
Dothan, AL 36305-1051

Mailing address

4300 W. Main Street
Suite 102
Dothan, AL 36305-1051
Phone (334) 793-9564

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, AL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20051219000978 CA Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Pulmonary Disease 5991727943 Reassigns benefits to 3 organizations
I20130906000688 AL Practitioner - Pulmonary Disease 5991727943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Internal Medicine, Pulmonary Disease
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - Intensivists PCGroup PAC ID 9032423421, 112 clinicians
St. John Critical Care Medical Group, IncGroup PAC ID 3476796780, 6 clinicians
Hany S Aziz MD IncGroup PAC ID 9931268075, 8 clinicians

Practice addresses (Care Compare)

1401 Garces Hwy
Delano, CA 93215-3660
Phone (661) 725-4800

2615 Chester Ave
Bakersfield, CA 93301-2014
Phone (661) 395-3000

3805 San Dimas St
Suite B
Bakersfield, CA 93301-5725
Phone (661) 326-9999

Hospital & facility affiliations

  • Adventist Health Bakersfield Hospital, Bakersfield, CA, CCN 050455
  • Bakersfield Memorial Hospital Hospital, Bakersfield, CA, CCN 050036
  • Adventist Health Delano Hospital, Delano, CA, CCN 050608
  • Adventist Health Tehachapi Valley Hospital, Tehachapi, CA, CCN 051301

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32733ALMDPulmonary Disease Physician
A72152CAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Houston County Healthcare Authority CurrentSince Sep 1, 2013 Accepting new patients
Hany S. Aziz M.D., Inc Pulmonary Disease CurrentSince Aug 5, 2024 Accepting new patients
Houston County Healthcare Authority Pulmonary Disease CurrentSince Sep 1, 2013 Accepting new patients
St. John Critical Care Medical Group, Inc CurrentSince Jun 3, 2018 Accepting new patients
Houston County Healthcare Authority Current Accepting new patients
Pathology Laboratory Associates Current Accepting new patients
Medcore Associates, PLLC Current Accepting new patients
Buena Vista Emergency Medical Services Past Accepting new patients
Triad of Alabama LLC Past Accepting new patients
Houston County Healthcare Authority Past Accepting new patients
Bakersfield Memorial Hospital Past Accepting new patients
Parikshat Sharma Inc PastSince Oct 1, 2011 Accepting new patients

Locations

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

2615 Chester Ave
Bakersfield, CA 93301
Phone (661) 381-7545

3805 San Dimas St
Ste B
Bakersfield, CA 93301
Phone (661) 326-9999

3805 San Dimas St
Bakersfield, CA 93301
Phone (661) 324-7300

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 4

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379030400000",
    "number": "1710080338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 W. MAIN STREET",
            "address_2": "SUITE 102",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051051",
            "telephone_number": "334-793-9564",
            "fax_number": "334-671-8907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 W. MAIN STREET",
            "address_2": "SUITE 102",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051051",
            "telephone_number": "334-793-9564",
            "fax_number": "334-671-8907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGALONG",
        "first_name": "MARY",
        "middle_name": "GRACE",
        "name_prefix": "Miss",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2013-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A72152",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AL",
            "license": "32733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.