Peter B Malench, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

03689542 Issued in IL

Practice address

10 Professional Park Dr
Maryville, IL 62062-5672

Phone

(618) 288-7244

NPI assigned

Nov 21, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL

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 1

Specialty

Family PracticeAlso: Emergency Medicine

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Small Hospital Innovations LLCGroup PAC ID 0840415444, 95 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Desoto Memorial Hospital Hospital, Arcadia, FL, CCN 100175

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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.

• Small Hospital Innovations LLC

  • Emergency Medicine Physician
  • Clewiston, FL
  • NPI 1184040560
  Medicare reassignment Care Compare group NPD
• Global Physician Network LLC Series II

  • Emergency Medicine Physician
  • Sarasota, FL
  • NPI 1821518028
  Medicare reassignment NPD

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

• Desoto County Hospital District

  • Rural Acute Care Hospital
  • Arcadia, FL
  • NPI 1528387842
  Care Compare affiliation

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435017600000",
    "number": "1760465165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PROFESSIONAL PARK DR",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625672",
            "telephone_number": "618-288-7244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PROFESSIONAL PARK DR",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625672",
            "telephone_number": "618-288-7244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALENCH",
        "first_name": "PETER",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2015-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "03689542",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036089542",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03089542",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204900500",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036089542",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Maggio, MS, RD, CSSD, LD
• Lisa Parke Maier, MD
• Paul G Malcharek, MD
• Malench & Malench MDS
• Anthony Malench, MD
• Lorianna Malito, OTR
• Michael E Mandis, MD
• Rachel M Mans, CBD
• Marjorie Garcia Counseling PLLC
• Mark Edelstein, MD, PC

• Family Medicine Physician in Maryville, IL
• Providers in Maryville, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2015; 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.