Eric John Mallico, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

2008-01430 Issued in NC

Practice address

1910 Jake Alexander Blvd W Ste 201
Salisbury, NC 28147-1165

Phone

(704) 638-8631

Fax

(704) 638-8639

NPI assigned

Mar 1, 2007

Last updated

Nov 28, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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

General Surgery

Education

University of Connecticut School of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Rowan Medical Center Hospital, Salisbury, NC, CCN 340015

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: emallico97863@direct.novanthealth.org

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.

• Novant Health Medical Group, LLC

  dba Novant Health Pediatric Neurology & Sleep

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment Care Compare group NPD
• DHP of North Carolina PC

  • Orthopaedic Surgery Physician
  • New Bern, NC
  • NPI 1780949032
  Medicare reassignment NPD
• Novant Health Medical Group, LLC

  dba Novant Health Elizabeth OB/GYN

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Inpatient Care Specialists Thomasville

  • Hospitalist Physician
  • Thomasville, NC
  • NPI 1720420797
  NPD
• Novant Medical Group, Inc.

  dba Mid Carolina Cardiology

  • Interventional Cardiology Physician
  • Charlotte, NC
  • NPI 1205836434
  NPD (past)

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

• Novant Health Rowan Medical Center LLC

  dba Novant Health Rowan Medical Center

  • General Acute Care Hospital
  • Salisbury, NC
  • NPI 1508843566
  Care Compare affiliation

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1790813863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 JAKE ALEXANDER BLVD W STE 201",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281471165",
            "telephone_number": "704-638-8631",
            "fax_number": "704-638-8639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Yadkin St",
            "address_2": "Suite 203",
            "address_purpose": "LOCATION",
            "city": "Albemarle",
            "state": "NC",
            "postal_code": "280013449",
            "country_code": "US",
            "telephone_number": "704-982-0161",
            "fax_number": "704-982-2361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLICO",
        "first_name": "ERIC",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2008-01430",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "116331",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5910179",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1511E",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "emallico97863@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1910 Jake Alexander Blvd W Ste 201",
            "city": "Salisbury",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281471165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Diana Mah, O.D.
• Caitlyn Ann Mahoney, LCSWA
• Lubabatu Inuwa Maimai
• Main Street Physical Therapy Inc
• Alexandra Elizabeth Malissen, PA-C
• James A Mallinson Jr., MA
• Sean I Malone, M.D.
• Sean Robert Maloney, M.D.
• Gary Lee Mancil, O.D.
• Brianna O'Neil Mangum, PA

• Surgery Physician in Salisbury, NC
• Providers in Salisbury, NC by specialty
• Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; 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.