Mallory Des Champs

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

7901 4TH Ave Ste A20
Brooklyn, NY 11209-3957

Phone

(718) 491-5800

Fax

(718) 748-2151

NPI assigned

Jun 3, 2019

Sex

Female

Sole proprietor

No

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 NY

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 1

Merit-based Incentive Payment System (MIPS)

Final score

85.97 of 100Reported as group

Quality

87.04

Promoting interoperability

77

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722

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.

• Ronald R Brancaccio MD & Peter Saitta DO PC

  • Dermatology Physician
  • Brooklyn, NY
  • NPI 1386719425
  Medicare reassignment
• Saitta Dermatology PC

  • Dermatology Physician
  • Brooklyn, NY
  • NPI 1083233324
  Medicare reassignment
• Live Beyond Medical MGMT LLC

  • Clinical Medical Laboratory
  • Delray Beach, FL
  • NPI 1386229938
  NPD (past)
• Siny Dermatology Florida

  • Dermatology Physician
  • Delray Beach, FL
  • NPI 1093565293
  NPD (past)

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

{
    "created_epoch": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577059200000",
    "number": "1740848985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 DOUGLAS PIKE",
            "city": "SMITHFIELD",
            "state": "RI",
            "postal_code": "029171291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 4TH AVE STE A20",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112093957",
            "telephone_number": "718-491-5800",
            "fax_number": "718-748-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DES CHAMPS",
        "first_name": "MALLORY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-03",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Muriel Dervich
• Samira Dervisevic Rezika, MSED, BCBA, NYS LBA
• Richard Faator Dery, MD
• Alan Derzie, MD
• Stacy Derzie
• Victoria Des Vignes
• Ami M Desai, M.D.
• Anubhooti Emmanuel Desai
• Bhadresh D Desai
• Chaula Desai

• Medical Physician Assistant in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.