NPIMap

Individual provider Active NPI

Timothy Robert Malinowski Jr., AGPCNP-BC

  • Gerontology Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1740893593
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
24219 Issued in SC
Practice address
1005 Grove Rd
Greenville, SC 29605-4630
Phone
(864) 455-6900
NPI assigned
Aug 30, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 24219 SC
Gerontology Nurse Practitioner 363LG0600X 24219 SC Primary

Addresses

Primary practice location

1005 Grove Rd
Greenville, SC 29605-4630

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8617

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tmalinowski34868@direct.ghs.myhfn.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20200929000025 SC Practitioner - Nurse Practitioner 3173942976 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

877 W Faris Rd
Suite B
Greenville, SC 29605-4296
Phone (864) 522-6225

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Sep 13, 2020 Accepting new patients
Prisma Health University Medical Group CurrentSince Sep 13, 2020 Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

877 W Faris Rd
Ste B
Greenville, SC 29605
Phone (864) 522-6225

1005 Grove Rd
Greenville, SC 29605
Phone (864) 235-7665

Interoperability endpoints

  • Direct secure messaging: tmalinowski34868@direct.ghs.myhfn.org

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 and National Provider Directory roles.

Hospital & facility affiliations 48

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1598745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1740893593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 GROVE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054630",
            "telephone_number": "864-455-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALINOWSKI",
        "first_name": "TIMOTHY",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-30",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "24219",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "SC",
            "license": "24219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tmalinowski34868@direct.ghs.myhfn.org",
            "affiliation": "N",
            "endpointDescription": "tmalinowski34868@direct.ghs.myhfn.org",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "tmalinowski34868@direct.ghs.myhfn.org",
            "address_1": "1005 Grove Rd",
            "city": "Greenville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296054630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.