Individual provider Active NPI

Kimberly N Mallin, M.D.

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Charleston, SC
National Provider Identifier
1750349502
Registry record updated May 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
License
21724 Issued in SC
Practice address
171 Ashley Ave
Charleston, SC 29425-0100
Phone
(843) 792-1414
NPI assigned
May 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X 292697 NY
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X 21724 SC Primary

Addresses

Primary practice location

171 Ashley Ave
Charleston, SC 29425-0100

Mailing address

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

Other practice location 1

8900 Van Wyck Expy
Richmond Hill, NY 11418-2832
Phone (718) 206-6000

Other identifiers 1

IdentifierTypeStateIssuer
217243MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.musc.edu Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NY2 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

Enrollment IDStateProvider typePAC IDDetails
I20080206000407 SC Practitioner - Family PracticePractitioner - Hospice/Palliative Care 5294818878 Reassigns benefits to 1 organization
I20220629001751 NY Practitioner - Family PracticePractitioner - Hospice/Palliative Care 5294818878 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative CareAlso: Family Practice
Education
Brody School of Medicine at East Carolina University, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

Merit-based Incentive Payment System (MIPS)

Final score
92.19 of 100Reported as group
Quality
82.16
Promoting interoperability
79
Improvement activities
40
Cost
75.98

Merit-based Incentive Payment System (MIPS)

Final score
79.02 of 100Reported as group
Quality
62.41
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21724SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Flushing Hospital Medical Center CurrentSince Jun 1, 2022 Accepting new patients
Flushing Hospital & Medical Center CurrentSince Jun 1, 2022 Accepting new patients
Jamaica Hospital CurrentSince Jun 1, 2022 Accepting new patients
Jamaica Hospital CurrentSince Jun 1, 2022 Accepting new patients
University Medical Associates of the Medical University of South Carol Family Medicine CurrentSince Jun 15, 2024 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Jun 15, 2024 Accepting new patients
Coastal Carolina Primary Care, LLC PastSince Aug 6, 2012 Accepting new patients

Locations

4500 Parsons Blvd
Flushing, NY 11355
Phone (718) 670-5631

14601 45th Ave
Flushing, NY 11355
Phone (718) 670-5562

80 Marcus Dr
Melville, NY 11747
Phone (631) 391-7889

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

8900 Van Wyck Expy
Richmond Hill, NY 11418
Phone (718) 206-6088

194 Spring St
Charleston, SC 29403
Phone (843) 754-6940

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

650 Ellis Oak Dr
Charleston, SC 29412
Phone (843) 266-1540

602 N Main St
Summerville, SC 29483
Phone (843) 876-2121

Networks

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

Interoperability endpoints

  • Direct secure messaging: kmallin5614@direct.musc.edu
  • Direct secure messaging: kmallin97342@direct.medisys.org
  • Direct secure messaging: kimberly.mallin.1@23284.direct.athenahealth.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778284800000",
    "number": "1750349502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258908",
            "telephone_number": "843-792-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294250100",
            "telephone_number": "843-792-1414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8900 Van Wyck Expy",
            "address_purpose": "LOCATION",
            "city": "Richmond Hill",
            "state": "NY",
            "postal_code": "114182832",
            "country_code": "US",
            "telephone_number": "718-206-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLIN",
        "first_name": "KIMBERLY",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2026-05-09",
        "certification_date": "2026-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "NY",
            "license": "292697",
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "SC",
            "license": "21724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "217243",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "171 Ashley Ave",
            "city": "Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294250100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.