NPIMap

Individual provider Active NPI

Kathryn Michelle Malan, M.D.

  • Family Medicine Physician
  • New Smyrna Beach, FL
National Provider Identifier
1740575497
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
TRN16249 Issued in FL
Practice address
125 Florida Memorial Pkwy Ste 2500
New Smyrna Beach, FL 32168-9315
Phone
(386) 409-6857
Fax
(386) 409-6911
NPI assigned
Jun 10, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TRN16249 FL Primary

Addresses

Primary practice location

125 Florida Memorial Pkwy Ste 2500
New Smyrna Beach, FL 32168-9315

Mailing address

125 Florida Memorial Pkwy Ste 2500
New Smyrna Beach, FL 32168-9315
Phone (386) 409-6857

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130812000482 FL Practitioner - Family PracticePractitioner - Emergency Medicine 5496992778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
University of Missouri, Columbia School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adventhealth Primary Care Network IncGroup PAC ID 1557722410, 428 clinicians

Practice addresses (Care Compare)

661 E Altamonte Dr
Suite 115
Altamonte Springs, FL 32701-5102
Phone (407) 831-4040

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TRN16249FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventhealth Primary Care Network Inc Family Medicine CurrentSince Aug 1, 2023 Accepting new patients
Halifax Healthcare Systems Inc Family Medicine Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

661 E Altamonte Dr
Ste 115
Altamonte Springs, FL 32701
Phone (407) 831-4040

125 Florida Memorial Pkwy
Ste 2500
New Smyrna Beach, FL 32168
Phone (386) 409-6850

125 Florida Memorial Pkwy
Ste 2700
New Smyrna Beach, FL 32168
Phone (386) 409-6871

Interoperability endpoints

  • Direct secure messaging: kmalan71016@adventhealth.direct-ci.com

Organizations & group practices 3

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 8

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": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1740575497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 FLORIDA MEMORIAL PKWY STE 2500",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321689315",
            "telephone_number": "386-409-6857",
            "fax_number": "386-409-6911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 FLORIDA MEMORIAL PKWY STE 2500",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321689315",
            "telephone_number": "386-409-6857",
            "fax_number": "386-409-6911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALAN",
        "first_name": "KATHRYN",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-10",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "TRN16249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Smyrna Beach, FL

Sources for this page

Verify at the official NPI Registry.