Michael Patrick Mallin, M.D.

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

MD182712 Issued in OR

Practice address

1253 NW Canal Blvd
Redmond, OR 97756-1334

Phone

(541) 548-8131

Fax

(541) 460-4028

NPI assigned

Oct 8, 2008

Last updated

Nov 1, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Clarity Precision Health LLC

  • Clinic/Center
  • Bend, OR
  • NPI 1720947005
  NPD Authorized official
• Cache Valley Specialty Hospital

  • General Acute Care Hospital
  • North Logan, UT
  • NPI 1669446563
  NPD (past)
• Matthew J Welter MD PC

  • Family Medicine Physician
  • Logan, UT
  • NPI 1871781252
  NPD (past)

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

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1730330788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1253 NW CANAL BLVD",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561334",
            "telephone_number": "541-548-8131",
            "fax_number": "541-460-4028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1253 NW CANAL BLVD",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561334",
            "telephone_number": "541-548-8131",
            "fax_number": "541-460-4028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 N 1900 E",
            "address_2": "Rm 1C026",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841320002",
            "country_code": "US",
            "telephone_number": "801-581-2730",
            "fax_number": "801-585-0603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLIN",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-08",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "UT",
            "license": "7152242-8905",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "OR",
            "license": "MD182712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500725416",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristine Maclean-Talbot
• Tyler Ray Main, PHARMD
• James Henry Majetich
• Isabel Makman, MD
• Tamatha Sue Makowsky
• Tara Maloney, LCSW
• Laura Mann, PT, DPT, OCS
• Mark S Keener DMD P.C.
• Ann L Martin, LCSW
• Levi Jeh Martin, PHARM.D.

• Emergency Medical Services (Emergency Medicine) Physician in Redmond, OR
• Providers in Redmond, OR by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.