Individual provider Active NPI

Palmer M Malinowski, AGACNP-BC

  • Gerontology Nurse Practitioner
  • Rome, GA
National Provider Identifier
1710538376
Registry record updated Sep 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
RN247722 Issued in GA
Practice address
501 Redmond Rd NW
Rome, GA 30165-1415
Phone
(706) 291-0291
NPI assigned
Sep 25, 2019
Last updated
Sep 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X RN247722 GA Primary

Addresses

Primary practice location

501 Redmond Rd NW
Rome, GA 30165-1415

Mailing address

430 Mary St
Centre, AL 35960-2028
Phone (910) 330-0942

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, AL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200428000097 GA Practitioner - Nurse Practitioner 5294165601 Reassigns benefits to 1 organization
I20201117000713 AL Practitioner - Nurse Practitioner 5294165601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amarabalan Rajendran, MD, PCGroup PAC ID 5991091373, 2 clinicians

Practice addresses (Care Compare)

801 Goodyear Ave
Gadsden, AL 35903-1133
Phone (516) 301-8155

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Amarabalan Rajendran, MD, PC CurrentSince Oct 1, 2020 Accepting new patients
Hospital Physician Services - Southeast Professional Corporation CurrentSince Feb 17, 2019 Accepting new patients

Locations

801 Goodyear Ave
Gadsden, AL 35903
Phone (256) 439-5000

3 Central Plz
Rome, GA 30161
Phone (516) 301-8155

501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291

Organizations & group practices 2

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 7

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": "1569369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1710538376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 MARY ST",
            "city": "CENTRE",
            "state": "AL",
            "postal_code": "359602028",
            "telephone_number": "910-330-0942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 REDMOND RD NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651415",
            "telephone_number": "706-291-0291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALINOWSKI",
        "first_name": "PALMER",
        "middle_name": "M",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-25",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN247722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.