Mallory McCabe, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD19949 Issued in RI

Practice address

6 Blackstone Valley PL Ste 306B
Lincoln, RI 02865-1112

Phone

(401) 334-4021

Fax

(401) 334-4886

NPI assigned

Mar 23, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in RI, MA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Lifespan Physician Group, Inc.

  • General Practice Physician
  • Providence, RI
  • NPI 1407116643

  MA

  Medicare reassignment NPD
• Lifespan Physician Group, Inc.

  • Emergency Medicine Physician
  • Providence, RI
  • NPI 1568325678

  Pediatrics

  NPD
• Lifespan Physician Group, Inc.

  • Psychiatry Physician
  • Providence, RI
  • NPI 1548506793
  NPD (past)

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1730765462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 BLACKSTONE VALLEY PL STE 306B",
            "city": "LINCOLN",
            "state": "RI",
            "postal_code": "028651112",
            "telephone_number": "401-334-4021",
            "fax_number": "401-334-4886"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "465 S Washington St Unit 4",
            "address_purpose": "LOCATION",
            "city": "North Attleboro",
            "state": "MA",
            "postal_code": "027602159",
            "country_code": "US",
            "telephone_number": "508-699-8444",
            "fax_number": "401-334-4886",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCABE",
        "first_name": "MALLORY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-23",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "MD19949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Russel John Masse, MASSAGE THERAPIST
• Meriem Matmati
• Enmanuel Matos, LMHC
• Joseph P Mazza, MD
• Mark A Mazzye Sr., PA-C
• Khallie McCaffrey
• Katherine D McCleary, M.D.
• Christine E McCulloch
• Chelsea Mical McKiernan, PA-C
• Laurie Jean McKinnon, M.S CCC-SLP

• Pediatrics Physician in Lincoln, RI
• Providers in Lincoln, RI by specialty
• Pediatrics Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.