Individual provider Active NPI

Ashley Mallon, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lynn, MA
National Provider Identifier
1790217958
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2312637 Issued in MA
Practice address
269 Union Street
Lynn, MA 01910-4956
Phone
(781) 581-3900
NPI assigned
Mar 28, 2017
Last updated
Oct 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2312637 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2312637 MA Primary

Addresses

Primary practice location

269 Union Street
Lynn, MA 01910-4956

Mailing address

34 Trident Ave Apt 4
Winthrop, MA 02152-1252
Phone (412) 606-8147

Other practice location 1

1677 Commonwealth Ave
Apt 2
Boston, MA 02135-4956
Phone (412) 606-7814

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20230330002362 MA Practitioner - Nurse Practitioner 8820463011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lynn Community Health, Inc.Group PAC ID 0042217507, 95 clinicians

Practice addresses (Care Compare)

20 Central Ave
Lynn, MA 01901-1314

269 Union St
Lynn, MA 01901-1314
Phone (959) 216-7305

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lynn Community Health, Inc. CurrentSince Feb 27, 2023 Accepting new patients

Locations

269 Union St
Lynn, MA 01901
Phone (781) 581-9832

280 Union St
Ste 202
Lynn, MA 01901
Phone (781) 780-4555

Interoperability endpoints

  • Direct secure messaging: amallon201241@direct.ochin.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1790217958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 TRIDENT AVE APT 4",
            "city": "WINTHROP",
            "state": "MA",
            "postal_code": "021521252",
            "telephone_number": "412-606-8147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 UNION STREET",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019104956",
            "telephone_number": "781-581-3900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1677 Commonwealth Ave",
            "address_2": "Apt 2",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021354956",
            "country_code": "US",
            "telephone_number": "412-606-7814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLON",
        "first_name": "ASHLEY",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-28",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2312637",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2312637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn, MA

Sources for this page

Verify at the official NPI Registry.