Shaunn Dominique Malaka, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

0103301025 Issued in VA

Practice address

14904 Jefferson Davis Hwy
Ste 105
Woodbridge, VA 22191-3908

Phone

(703) 490-8171

Fax

(703) 490-8172

NPI assigned

Mar 16, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, DC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Podiatry

Education

College of Podiatric Med and Surgery, Des Moines University, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sentara Northern Virginia Medical Center Hospital, Woodbridge, VA, CCN 490113

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• S. Carrington, Inc

  • Foot & Ankle Surgery Podiatrist
  • Woodbridge, VA
  • NPI 1700106424

  DC

  Medicare reassignment Authorized official

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

• Potomac Hospital Corporation of Prince William

  • General Acute Care Hospital
  • Woodbridge, VA
  • NPI 1548366404
  Care Compare affiliation

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

{
    "created_epoch": "1237161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515628800000",
    "number": "1770724148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14904 JEFFERSON DAVIS HWY",
            "address_2": "STE 105",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913908",
            "telephone_number": "703-490-8171",
            "fax_number": "703-490-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14904 JEFFERSON DAVIS HWY",
            "address_2": "STE 105",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913908",
            "telephone_number": "703-490-8171",
            "fax_number": "703-490-8172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALAKA",
        "first_name": "SHAUNN",
        "middle_name": "DOMINIQUE",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-16",
        "last_updated": "2018-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CO",
            "license": "684",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MD",
            "license": "01481",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "DC",
            "license": "PO1000072",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "VA",
            "license": "0103301025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Houshang Makipour, M.D.
• Kian Makipour, MD
• Malachi Medical Supplies
• Summer Lynn Claveau Malaguerra, M.ED, BCBA LBA
• Morley Malaka
• Aracely Maldonado
• Eduardo Jose Maldonado
• Sahar Malik, BEHAVIOR ASSISTANT
• Mohammad Omar Malikasghar
• Chad Malone, PT

• Foot & Ankle Surgery Podiatrist in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Foot & Ankle Surgery Podiatrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2018; 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.